Author(s)
Ahmed et al.[1]
Country of
Year
Study
2013 Pakistan
Min
Age
Paediatric Overall
Follow
MINORS range
sample
closure
up
Study design
Score
(mean) size /ears rate /% /months
Graft material
Retrospective 9
11-16
10
100.0
12
Cartilage/
cohort
(14.1)
perichondrium
Graft position/
technique
Inlay
Paediatric
tympanoplsty
main focus of
study?
n
Includes other
types of
tympanoplasty
n
Al-Khtoum and
Hiari[2]
2009
Jordan
Retrospective 8
cohort
9-14
(12)
35
85.7
12
Temporalis fascia Underlay
y
n
Albera et al.[3]
2006
Italy
Retrospective 7
cohort
?-17 (-)
25
84.0
60
Temporalis fascia Underlay or onlay n
n
Albirmawy[4]
2010
Egypt
Retrospective 10
cohort
5-15
(12.0)
82
85.4
12
y
n
Anderson and
Takwoingi[5]
2007
UK
Retrospective 8
cohort
8-16 (-)
12
91.7
9
Cartilage/
Underlay
perichondrium or
temporalis fascia
Temporalis fascia Underlay
n
n
Ayache et al.[6]
2003
France
Retrospective 9
cohort
4-14 (-)
15
80.0
6
Abdominal fat
n
n
Bajaj et al.[7]
1998
India
Retrospective 6
cohort
5-14 (-)
45
91.1
12
Temporalis fascia Underlay or onlay y
n
Castro et al.[8]
2013
Spain
Retrospective 9
cohort
7-14
(11.5)
81
84.0
12
y
n
Caylan et al.[9]
1998
Italy
Retrospective 9
cohort
5-16 (-)
51
82.4
18
Cartilage/
Underlay or inlay
perichondrium or or onlay
temporalis fascia
Temporalis fascia Underlay
y
n
Couloigner et
al.[10]
2005
France
Retrospective 8
cohort
3-17
(9.9)
59
71.2
12
Cartilage
y
y
D’Eredità and
Lens[11]
2009
UK
Randomized
controlled
trial
-
3-14
(9.5*)
111
89.2
24
Temporalis fascia Underlay or
underlay
(anterior flap)
y
n
Dündar et al.[12]
2014
Turkey
Retrospective 8
cohort
7-16
(12.2)
61
90.2
12
Cartilage/
perichondrium
y
n
Inlay
Inlay
Underlay
Effat[13]
2005
Egypt
Retrospective 9
cohort
8-18
(14.1)
?-? (9.9)
11
27.3
8
Cartilage
21
90.5
13
Inlay
n
n
Temporalis fascia Underlay
or areolar
connective tissue
y
n
Eisenbeis and
Herrmann[14]
2004
USA
Retrospective 10
cohort
El-Hennawi[15]
2001
Egypt
Retrospective 8
cohort
5-16
(13.9)
30
86.7
12
Cartilage/
perichondrium
Underlay
y
y
Gaslin et al.[16]
2007
USA
Retrospective 9
cohort
3-16
(7.9)
42
95.2
12
Cartilage/
perichondrium
Interleave
(sandwiched
between fibrous
and squamous
layers)
y
n
Goldman[17]
2007
New Zealand Retrospective 9
cohort
Not
stated
17
47.1
72
Silver nitrate
cautery or Urea
and paper patch
Silver nitrate
cautery (4/5)
Urea and paper
patch (4/12)
n
n
Gupta and
Mishra[18]
2002
India
Retrospective 7
cohort
8-15 (-)
52
88.5
6
Not stated
Not stated
y
n
Halim and
Borgstein[19]
2009
Netherlands
Retrospective 8
cohort
5-18
(10.0*)
218
71.1
12
Temporalis fascia Underlay
y
n
Harterink et
al.[20]
2014
France
Retrospective 8
cohort
4-16
(10.5)
64
84.4
10
Cartilage/
perichondrium
y
n
Hung et al.[21]
2004
UK
Prospective
cohort
7-16
(11.9)
56
96.4
12
Temporalis fascia Underlay
(anterosuperior
anchoring)
n
n
Kumar et al.[22]
2010
UK
Retrospective 10
cohort
6-16
(10.6)
98
67.3
12
not specified
Not stated
y
n
Landsberg et
al.[23]
2006
Israel
Retrospective 8
cohort
8-15
(13)
11
72.7
25
Lobule fat
Inlay
n
n
Mak et al.[24]
2004
Australia
Prospective
cohort
5-15
(10)
67
50.7
6
Temporalis fascia Underlay or inlay
or perichondrium or onlay
or cartilage or fat
y
n
9
11
Underlay
Merenda et al.[25] 2007
USA
Retrospective 9
cohort
4-16
(10.2)
58
58.6
6
Temporalis fascia Underlay
y
n
Migirov and
Volkov[26]
2009
Israel
Retrospective 8
cohort
6-16
(9.9)
40
92.5
12
Temporalis fascia Underlay
y
n
Ozbek et al.[27]
2008
Turkey
Retrospective 7
cohort
8-16
(12.1)
45
84.4
12
Cartilage/
perichondrium
palisade or
temporalis fascia
y
n
Pignataro et
al.[28]
2001
Italy
Retrospective 7
cohort
8-14
(10.8)
41
80.5
8
Temporalis fascia Underlay or onlay y
n
Ribeiro et al.[29]
2011
Portugal
Retrospective 7
cohort
6-17
(12.0)
91
85.7
6
Temporalis fascia Underlay
y
n
Ryan et al.[30]
2002
UK
Retrospective 10
cohort
7-16
(11.7)
71
91.5
12
Temporalis fascia Underlay
y
n
Saliba and
Froehlich[31]
2011
Canada
Prospective
cohort
10
4-16
(12.2)
208
88.5
12
Fat with
hyaluronic acid
epidisc or
perichondrium
Underlay or onlay y
n
Saliba et al.[32]
2012
Canada
Prospective
cohort
12
4-17
(11.7)
92
75.0
12
y
n
Singh et al.[33]
2005
India
Prospective
cohort
9
8-14 (-)
20
80.0
6
Fat and fat with
Underlay or inlay
hyaluronic acid
epidisc
Temporalis fascia Inlay
y
n
Srinivasan et
al.[34]
1997
UK
Retrospective 7
cohort
9-16
(12.4)
40
77.5
6
Temporalis fascia Underlay
y
n
Takahashi et
al.[35]
2014
Japan
Retrospective 8
cohort
2-16
(8.7)
67
80.6
12
Not stated
y
n
Te et al.[36]
1998
USA
Retrospective 9
cohort
3-16
(10.8)
93
94.6
10
Temporalis fascia Underlay or onlay y
n
Tos et al.[37]
2000
Denmark
Retrospective 8
cohort
2-14 (-)
124
94.4
6
Not stated
y
y
Umapathy and
Dekker[38]
2003
UK
Retrospective 9
cohort
4-14 (-)
89
92.1
12
Temporalis fascia Underlay
y
n
Underlay
Not stated
Not stated
Usami et al.[39]
2001
Japan
Retrospective 7
cohort
6-14
(11.3)
4
100.0
6
n
12
"Connective
Underlay
n
tissue" or
temporalis fascia
Temporalis fascia Underlay or onlay y
Uyar et al.[40]
2006
Turkey
Retrospective 8
cohort
8-16
(15.1)
41
90.2
Vartiainen and
Vartiainen[41]
1997
Finland
Retrospective 8
cohort
5-17
(11.1)
60
95.0
60
Temporalis fascia Underlay or onlay y
n
Yilmaz et al.[42]
2013
Turkey
Retrospective 7
cohort
7-16
(13.1)
45
91.1
6
Cartilage
n
n
Yoon et al.[43]
2007
Korea
Retrospective 8
cohort
3-15
(11.1)
63
95.2
12
Temporalis fascia Not stated
y
n
Yu and Yoon[44]
2010
Korea
Retrospective 7
cohort
9-12
(10.3)
4
100.0
9
Cartilage
n
n
Yung et al.[45]
2007
UK
Retrospective 10
cohort
4-13 (-)
39
84.6
12
Temporalis fascia Underlay
or perichondrium
or cartilage
y
n
Underlay
Inlay
y
1
2
3
Supplemental digital content: Table 2:
Characteristics of included studies and MINORS (Methodological Index for Non-Randomized Studies) scores. *denotes
median age presented where mean not available.
1.
Ahmed S, Raza N, Ullah S, Shabbir A. Chondroperichondrial clip myringoplasty: a new technique for closure
of tympanic membrane perforations. J Laryngol Otol 2013;127(6):562–7.
2.
Al-Khtoum N, Hiari MA. Myringoplasty in children: retrospective analysis of 35 cases. Braz J
Otorhinolaryngol 2009;75(3):371–4.
3.
Albera R, Ferrero V, Lacilla M, Canale A. Tympanic reperforation in myringoplasty: evaluation of prognostic
factors. Ann Otol Rhinol Laryngol 2006;115(12):875–9.
4.
Albirmawy OA. Comparison between cartilage-perichondrium composite “ring” graft and temporalis fascia
in type one tympanoplasty in children. J Laryngol Otol 2010;124(9):967–74.
5.
Anderson O, Takwoingi YM. Tri-adcortyl ointment ear dressing in myringoplasty: an analysis of outcome.
Eur Arch Otorhinolaryngol 2007;264(8):873–7.
6.
Ayache S, Braccini F, Facon F, Thomassin JM. Adipose graft: an original option in myringoplasty. Otol
Neurotol 2003;24(2):158–64.
7.
Bajaj Y, Bais AS, Mukherjee B. Tympanoplasty in children--a prospective study. J Laryngol Otol
1998;112(12):1147–9.
8.
Castro O, Pérez-Carro AM, Ibarra I, Hamdan M, Meléndez JM, Araujo A, et al. Myringoplasties in children: our
results. Acta Otorrinolaringológica Esp 2013;64(2):87–91.
9.
Caylan R, Titiz A, Falcioni M, De Donato G, Russo A, Taibah A, et al. Myringoplasty in children: factors
influencing surgical outcome. Otolaryngol Head Neck Surg 1998;118(5):709–13.
10.
Couloigner V, Baculard F, El Bakkouri W, Viala P, François M, Narcy P, et al. Inlay butterfly cartilage
tympanoplasty in children. Otol Neurotol 2005;26(2):247–51.
11.
D’Eredità R, Lens MB. Anterior tab flap versus standard underlay myringoplasty in children. Otol Neurotol
2009;30(6):777–81.
12.
Dündar R, Kulduk E, Soy FK, Aslan M, Hanci D, Muluk NB, et al. Endoscopic versus microscopic approach to
type 1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol 2014;78(7):1084–9.
13.
Effat KG. Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane
perforations. J Laryngol Otol 2005;119(8):611–3.
14.
Eisenbeis JF, Herrmann BW. Areolar connective tissue grafts in pediatric tympanoplasty: a pilot study. Am J
Otolaryngol 2004;25(2):79–83.
15.
El-Hennawi DM. Cartilage perichondrium composite graft (CPCG) in pediatric tympanoplasty. Int J Pediatr
Otorhinolaryngol 2001;59(1):1–5.
16.
Gaslin M, O’Reilly RC, Morlet T, McCormick M. Pediatric cartilage interleave tympanoplasty. Otolaryngol-Head Neck Surg 2007;137(2):284–8.
17.
Goldman NC. Chemical closure of chronic tympanic membrane perforations. ANZ J Surg 2007;77(10):850–1.
18.
Gupta N, Mishra RK. Tympanoplasty in children. Indian J Otolaryngol Head Neck Surg 2002;54(4):271–3.
19.
Halim A, Borgstein J. Pediatric myringoplasty: postaural versus transmeatal approach. Int J Pediatr
Otorhinolaryngol 2009;73(11):1580–3.
20.
Harterink E, Leboulanger N, Kotti S, Garabedian E-N, Denoyelle F. Results of myringoplasty in children with
cleft palate: a patient-matched study. Otol Neurotol 2014;35(5):838–43.
21.
Hung T, Knight JR, Sankar V. Anterosuperior anchoring myringoplasty technique for anterior and subtotal
perforations. Clin Otolaryngol Allied Sci 2004;29(3):210–4.
22.
Kumar S, Acharya A, Hadjihannas E, Panagamuwa C, McDermott AL. Pediatric myringoplasty: definition of
“success” and factors affecting outcome. Otol Neurotol 2010;31(9):1417–20.
23.
Landsberg R, Fishman G, DeRowe A, Berco E, Berger G. Fat graft myringoplasty: results of a long-term
follow-up. J Otolaryngol 2006;35(1):44–7.
24.
Mak D, MacKendrick A, Bulsara M, Coates H, Lannigan F, Lehmann D, et al. Outcomes of myringoplasty in
Australian Aboriginal children and factors associated with success: a prospective case series. Clin
Otolaryngol Allied Sci 2004;29(6):606–11.
25.
Merenda D, Koike K, Shafiei M, Ramadan H. Tympanometric volume: a predictor of success of tympanoplasty
in children. Otolaryngol--Head Neck Surg 2007;136(2):189–92.
26.
Migirov L, Volkov A. Influence of coexisting myringosclerosis on myringoplasty outcomes in children. J
Laryngol Otol 2009;123(9):969–72.
27.
Ozbek C, Ciftçi O, Tuna EEU, Yazkan O, Ozdem C. A comparison of cartilage palisades and fascia in type 1
tympanoplasty in children: anatomic and functional results. Otol Neurotol 2008;29(5):679–83.
28.
Pignataro L, Grillo Della Berta L, Capaccio P, Zaghis A. Myringoplasty in children: anatomical and functional
results. J Laryngol Otol 2001;115(5):369–73.
29.
Ribeiro JC, Rui C, Natercia S, Jose R, Antonio P. Tympanoplasty in children: A review of 91 cases. Auris Nasus
Larynx 2011;38(1):21–5.
30.
Ryan C, Harris R, Hung T, Knight J. Paediatric day-stay myringoplasty: a review of 74 consecutive cases. J
Laryngol Otol 2002;116(11):899–902.
31.
Saliba I, Froehlich P. Hyaluronic acid fat graft myringoplasty: an office-based technique adapted to children.
Arch Otolaryngol Head Neck Surg 2011;137(12):1203–9.
32.
Saliba I, Knapik M, Froehlich P, Abela A. Advantages of hyaluronic acid fat graft myringoplasty over fat graft
myringoplasty. Arch Otolaryngol - Head Neck Surg 2012;138(10):950–5.
33.
Singh GB, Sidhu TS, Sharma A, Singh N. Tympanoplasty type I in children--an evaluative study. Int J Pediatr
Otorhinolaryngol 2005;69(8):1071–6.
34.
Srinivasan V, Toynton SC, Mangat KS. Transtympanic myringoplasty in children. Int J Pediatr
Otorhinolaryngol 1997;39(3):199–204.
35.
Takahashi-Tatsumi E, Mishiro Y, Katsura H, Sakaguchi A, Sakagami M. Longitudinal follow-up after pediatric
myringoplasty: long-term outcome is defined at 12 months. Otol Neurotol 2014;35(1):126–8.
36.
Te GO, Rizer FM, Schuring AG. Pediatric tympanoplasty of iatrogenic perforations from ventilation tube
therapy. Am J Otol 1998;19(3):301–5.
37.
Tos M, Orntoft S, Stangerup SE. Results of tympanoplasty in children after 15 to 27 years. Ann Otol Rhinol
Laryngol 2000;109(1):17–23.
38.
Umapathy N, Dekker PJ. Myringoplasty: is it worth performing in children? Arch Otolaryngol Head Neck Surg
2003;129(10):1053–5.
39.
Usami S, Iijima N, Fujita S, Takumi Y. Endoscopic-assisted myringoplasty. ORL 2001;63(5):287–90.
40.
Uyar Y, Keleş B, Koç S, Oztürk K, Arbağ H. Tympanoplasty in pediatric patients. Int J Pediatr
Otorhinolaryngol 2006;70(10):1805–9.
41.
Vartiainen E, Vartiainen J. Tympanoplasty in young patients: the role of adenoidectomy. Otolaryngol Head
Neck Surg 1997;117(6):583–5.
42.
Yilmaz MS, Guven M, Kayabasoglu G, Varli AF. Comparison of the anatomic and hearing outcomes of cartilage
type 1 tympanoplasty in pediatric and adult patients. Eur Arch Otorhinolaryngol 2013;
43.
Yoon TH, Park S-K, Kim JY, Pae KH, Ahn JH. Tympanoplasty, with or without mastoidectomy, is highly
effective for treatment of chronic otitis media in children. Acta Oto-Laryngol Suppl 2007;(558):44–8.
44.
Yu MS, Yoon TH. Bilateral same-day surgery for bilateral perforated chronic otitis media: Inlay butterfly
cartilage myringoplasty. Otolaryngol--Head Neck Surg 2010;143(5):669–72.
45.
Yung M, Neumann C, Vowler SL. A longitudinal study on pediatric myringoplasty. Otol Neurotol
2007;28(3):353–5.