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Fascia compared to one‐piece composite cartilage‐perichondrium grafting for tympanoplasty
Author(s) -
Lyons Sarah A.,
Su Tanly,
Vissers Linda E. T.,
Peters Jeroen P. M.,
Smit Adriana L.,
Grolman Wilko
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25772
Subject(s) - tympanoplasty , medicine , perichondrium , surgery , tympanic membrane perforation , perforation , cochrane library , fascia , myringoplasty , cartilage , randomized controlled trial , anatomy , materials science , metallurgy , punching
Objective To evaluate the effectiveness of type 1 tympanoplasty with one‐piece composite cartilage‐perichondrium (CCP) grafts compared to temporalis fascia (TF) grafts for tympanic membrane (TM) closure and hearing improvement in adult patients with a subtotal TM perforation and chronic otitis media (COM). Data Sources PubMed, Embase, Cochrane Library. Review Methods A systematic search was conducted. Relevance and validity of selected articles were assessed. Studies that scored moderate or high on relevance were included, and relevant data for both outcomes were extracted. For the outcome of TM closure, absolute risk differences (RD), relative risks, and number needed to treat with their respective 95% confidence intervals were calculated when possible. Results We retrieved 3,783 unique studies. Ten studies satisfied the eligibility criteria. Four studies of moderate validity showed RD ranging from 0.08 to 0.13 in favor of the CCP graft compared to the TF graft for TM closure 1 year or more postoperatively, but this was not statistically significant. Five studies of moderate to high validity showed no clinically relevant difference in hearing improvement between both intervention groups at a minimum follow‐up of 3 months. The relative air‐bone gap closure ranged from 5.7 to 11.5 dB in the TF group and from 8.9 to 12.7 dB in the CCP group. Conclusions There is no evidence of superiority of one‐piece CCP grafting over TF grafting in type 1 tympanoplasty regarding complete closure of a subtotal perforated TM 1 year or more postoperatively or hearing improvement at a minimum of 3 months follow‐up. Laryngoscope , 126:1662–1670, 2016