Objectives: To evaluate the impact of allograft and xenograft in pediatric tympanoplasty on patient outcomes.
Methods: A retrospective cohort study of 50 pediatric patients undergoing tympanoplasty at a single tertiary pediatric hospital system that received either autograft, allograft, or xenograft. Patients were evaluated for persistent perforation, recurrent perforation, revision surgery, and postoperative infection. Hearing outcomes, operative charges, and operative time were also evaluated. Statistical analyses included chi-square and Fisher exact tests for categorical data and Wilcoxon-Mann-Whitney tests for continuous data.
Results: Half of the cohort received autografts, whereas 38% received xenografts and 14% received allografts. Although there was not a significant difference in charges associated with these procedures, xenografts had the shortest mean operative time (mean: 39 vs 68 minutes in autografts, p = .05). Overall, the rate of persistent perforation was 10%, recurrent perforation was 20%, revision surgery was 16%, and postoperative infection was 18%. There were no differences in the rates of these outcomes by graft type. Furthermore, there was no observed difference in hearing outcomes among autograft and xenograft recipients, but allograft recipients had significantly improved hearing postoperatively.
Conclusions: Similar rates of complications were observed among autografts, xenografts, and allografts, providing preliminary evidence that they are safe to use in pediatric tympanoplasty.
Keywords: acellular matrix; allograft; comparative effectiveness; myringoplasty; pediatric; tympanoplasty; xenograft.