Do the Angle and Length of the Eustachian Tube Affect the Success Rate of Pediatric Cartilage Type 1 Tympanoplasty?.

Objectives: To investigate the relationships between the angle and length of the Eustachian tube (ET) (the ETa and the ETl) and the success rates of pediatric type 1 tympanoplasty. Study design: A retrospective clinical chart review. Methods: In total, 51 children (31 females and 20 males; average age, 11.92 +/- 3.46 years; age range: 7-18 years) who underwent cartilage type 1 tympanoplasty were included. Demographics and anatomical outcomes were recorded. The patients were divided into 2 groups in terms of anatomical success. In group A, all patients had intact grafts without perforation, retraction, or lateralization, and a dry ear, at 6 months postoperatively. In group B, reperforation of the tympanic membrane was evident 6 months postoperatively. The average ETa and ETl values of each group were measured on computed tomography images using a multiplanar reconstruction technique, and compared. Results: The ETa values of diseased ears of males and females were, respectively, 26.60 +/- 6.42[degrees] and 23.29 +/- 6.51[degrees], compared to 27.25 +/- 5.23[degrees] and 23.32 +/- 4.61[degrees] for normal male and female ears, respectively. In group A, the ETa was 26.46 +/- 6.82[degrees] in males and 22.95 +/- 7.50[degrees] in females. In group B, the ETa was 26.85 +/- 6.12[degrees] in males and 23.90 +/- 4.45[degrees] in females. In group A, the mean ETl was 41.0 mm (29.6-45.3 mm) in males and 37.9 mm (32.0-44.5 mm) in females. In group B, the mean ETl was 40.5 mm (30.5-47.1 mm) in males and 38.0 mm (32.8-45.0 mm) in females. In group A, the ETa value of diseased ears did not differ between females and males, but in normal ears, the ETa was higher in males than females (P = 0.020 and P 0.05). No difference in the ETl values of diseased and normal ears, in either group, was apparent between females and males (both P > 0.05). Conclusions: Neither the ETa nor the ETl affected the success rate of pediatric cartilage type 1 tympanoplasty. Further studies with larger numbers of patients are needed to compare anatomical outcomes after placement of various graft types and the effects of anatomical features of the ET on the success rate of pediatric tympanoplasty. (C) 2017 by Mutaz B. Habal, MD.

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