Endoscopic Versus Microscopic Type I Tympanoplasty : An Updated Systematic Review and Meta-analysis
© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation..
OBJECTIVE: Our objective was to perform a systematic review and meta-analysis comparing the clinical outcomes after endoscopic and microscopic type I tympanoplasty.
STUDY DESIGN: Randomized controlled trials, two-arm prospective studies, and retrospective studies were included.
SETTING: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until March 1, 2022 using the combinations of search terms: "endoscopic," "microscopic," and "tympanoplasty.".
METHODS: Two independent reviewers utilized the abovementioned search strategy to identify eligible studies. If any uncertainty existed regarding eligibility, a third reviewer was consulted. Primary outcome measures were graft success rate, air-bone gap (ABG) improvement, and operative time. Secondary outcomes were the rate of need for canalplasty, the proportion of self-rated excellent cosmetic results, and pain visual analog scale (VAS).
RESULTS: Forty-three studies enrolled a total of 3712 patients who were undergoing type I tympanoplasty and were finally included. The pooled result showed endoscopic approach was significantly associated with shorter operative time (difference in means: -20.021, 95% confidence interval [CI]: -31.431 to -8.611), less need for canalplasty (odds ratio [OR]: 0.065, 95% CI: 0.026-0.164), more self-rated excellent cosmetic results (OR: 87.323, 95% CI: 26.750-285.063), and lower pain VAS (difference in means: -2.513, 95% CI: -4.737 to -0.228). No significant differences in graft success rate or ABG were observed between the two procedures.
CONCLUSION: Endoscopic type I tympanoplasty provides a similar graft success rate, improvement in ABG, and reperforation rate to microscopic tympanoplasty with a shorter operative time, better self-rated cosmetic results, and less pain. Unless contraindicated, the endoscopic approach should be the procedure of choice in type I tympanoplasty.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:170 |
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| Enthalten in: |
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery - 170(2024), 3 vom: 20. Feb., Seite 675-693 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wang, Tang-Chuan [VerfasserIn] |
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| Links: |
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| Themen: |
Endoscopic |
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| Anmerkungen: |
Date Completed 28.02.2024 Date Revised 28.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ohn.597 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366314017 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation. | ||
| 520 | |a OBJECTIVE: Our objective was to perform a systematic review and meta-analysis comparing the clinical outcomes after endoscopic and microscopic type I tympanoplasty | ||
| 520 | |a STUDY DESIGN: Randomized controlled trials, two-arm prospective studies, and retrospective studies were included | ||
| 520 | |a SETTING: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until March 1, 2022 using the combinations of search terms: "endoscopic," "microscopic," and "tympanoplasty." | ||
| 520 | |a METHODS: Two independent reviewers utilized the abovementioned search strategy to identify eligible studies. If any uncertainty existed regarding eligibility, a third reviewer was consulted. Primary outcome measures were graft success rate, air-bone gap (ABG) improvement, and operative time. Secondary outcomes were the rate of need for canalplasty, the proportion of self-rated excellent cosmetic results, and pain visual analog scale (VAS) | ||
| 520 | |a RESULTS: Forty-three studies enrolled a total of 3712 patients who were undergoing type I tympanoplasty and were finally included. The pooled result showed endoscopic approach was significantly associated with shorter operative time (difference in means: -20.021, 95% confidence interval [CI]: -31.431 to -8.611), less need for canalplasty (odds ratio [OR]: 0.065, 95% CI: 0.026-0.164), more self-rated excellent cosmetic results (OR: 87.323, 95% CI: 26.750-285.063), and lower pain VAS (difference in means: -2.513, 95% CI: -4.737 to -0.228). No significant differences in graft success rate or ABG were observed between the two procedures | ||
| 520 | |a CONCLUSION: Endoscopic type I tympanoplasty provides a similar graft success rate, improvement in ABG, and reperforation rate to microscopic tympanoplasty with a shorter operative time, better self-rated cosmetic results, and less pain. Unless contraindicated, the endoscopic approach should be the procedure of choice in type I tympanoplasty | ||
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| 700 | 1 | |a Chen, Chin-Kuo |e verfasserin |4 aut | |
| 700 | 1 | |a Hsieh, Vivian Chia-Rong |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Dan-Jae |e verfasserin |4 aut | |
| 700 | 1 | |a Tien, Hui-Chi |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Kuang-Chao |e verfasserin |4 aut | |
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| 700 | 1 | |a Tsai, Chon-Haw |e verfasserin |4 aut | |
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