O'Leary, Stephen

Darke, Amelia

Currie, Kathy

Ozdowska, Katie

Patel, Hemi

2019-12

To report the surgical and audiological outcomes of myringoplasty (Type I tympanoplasty) in Indigenous Australian children living in remote and regional communities in northern Australia. An observational cohort study, with prospective recording of the details of surgery. Audiological outcomes were collected independently, and these data were integrated in the present study. Children aged 5-18 year underwent myringoplasty in the Northern Territory during a program initiated by the Australian Government. Surgery was performed by surgeons drawn from across Australia. 412 primary myringoplasties were performed. The mean age at surgery was 11 years. The tympanic membrane was closed in 64.2% of cases. Fascial grafting was associated with greater surgical success than cartilage. Dryness of the ear at surgery did not affect drum closure. Post-operative aural discharge was half that reported in historical literature. Surgical success was independent of the patient's age at surgery. Post-operative audiograms were available on 216 cases. At last review, hearing had improved even when the operation was not a surgical success, with hearing aid candidacy falling from 84 to 34%. Hearing was similar irrespective of the size of the perforation at surgery or the graft used and did not change with the time between surgery and review. The best hearing was associated with drum closure and Types A or C tympanograms. A conductive hearing loss persisted after surgery that was greater when there was an immobile drum. Indigenous children benefited from myringoplasty, even when the operation was not a "surgical success" as deemed by drum closure. There lower incidence of post-operative discharge from persistent perforations suggests an improvement in the ear health of the population. A persistent conductive loss persists, likely a consequence of the underlying disease but possibly from the surgery.

Department of Otolaryngology - Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia; Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Electronic address: sjoleary@unimelb.edu.au..

Department of Otolaryngology - Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia..

Department of Health, Northern Territory Government, Australia..

Department of Otolaryngology - Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia..

Royal Darwin Hospital, Northern Territory Government, Australia..

International journal of pediatric otorhinolaryngology 2019-12; 127: 109634

https://pubmed.ncbi.nlm.nih.gov/31505433/?otool=iaurydwlib

https://hdl.handle.net/10137/7909

Australian Aboriginal

First nations

Indigenous

Myringoplasty

Tympanoplasty

Outcomes of primary myringoplasty in indigenous children from the Northern Territory of Australia.

Journal Article

Publication