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Endoscopic Versus Microscopic Type I Tympanoplasty: An Updated Systematic Review and Meta-analysis.
Wang, Tang-Chuan; Shih, Tzu-Ching; Chen, Chin-Kuo; Hsieh, Vivian Chia-Rong; Lin, Dan-Jae; Tien, Hui-Chi; Chen, Kuang-Chao; Tsai, Ming-Hsui; Lin, Chia-Der; Tsai, Chon-Haw.
Afiliación
  • Wang TC; Department of Otolaryngology-Head and Neck Surgery, Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.
  • Shih TC; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
  • Chen CK; Department of Master Program for Biomedical Engineering, College of Biomedical Engineering, China Medical University, Taichung, Taiwan.
  • Hsieh VC; Department of Otolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung, Taiwan.
  • Lin DJ; Department of Biomedical Imaging and Radiological Science, College of Medicine, China Medical University, Taichung, Taiwan.
  • Tien HC; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
  • Chen KC; Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan.
  • Tsai MH; Department of Department of Biomedical Engineering, College of Biomedical Engineering, China Medical University, Taichung, Taiwan.
  • Lin CD; Department of Otolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung, Taiwan.
  • Tsai CH; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Otolaryngol Head Neck Surg ; 170(3): 675-693, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38140741
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Timpanoplastia / Endoscopía Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Timpanoplastia / Endoscopía Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido