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Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: A systematic review and meta‐analysis
Author(s) -
Tseng ChihChieh,
Lai MingTang,
Wu ChiaChe,
Yuan ShengPo,
Ding YiFang
Publication year - 2017
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.26379
Subject(s) - tympanoplasty , medicine , surgery , meta analysis , confidence interval
Objectives Microscopic tympanoplasty has been the standard surgery for repairing perforated tympanic membranes since the 1950s, but endoscopic tympanoplasty has been increasingly practiced since the late 1990s. In this study, we compared the efficacies of endoscopic and microscopic tympanoplasty. Data Sources PubMed, Embase, MEDLINE, and the Clinical Trial Register. Review Methods We conducted a systematic review and meta‐analysis following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement. We included clinical studies that compared the efficacies of endoscopic and microscopic tympanoplasty. We assessed the risk of bias and calculated the pooled relative risk (RR) estimates with 95% confidence interval (CI). Results We identified four studies (involving 266 patients in total) that met the inclusion criteria. The pooled tympanic membrane closure rates and hearing results of endoscopic and microscopic tympanoplasty were comparable (85.1% vs. 86.4%, respectively; RR: 0.98; 95% CI: 0.85 to 1.11; I 2 = 0) (mean difference of improvements of air‐bone gaps: −2.73; 95% CI: −6.73 to 1.28; I 2 = 80%). The pooled canalplasty rate of endoscopic tympanoplasty was significantly lower than that of microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty had a more desirable cosmetic result than did those receiving microscopic tympanoplasty. Conclusions Our up‐to‐date review evidences the comparable tympanic membrane closure rates and hearing results for endoscopic and microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty have a lower canalplasty rate and more desirable cosmetic result than do those receiving microscopic tympanoplasty. Laryngoscope , 127:1890–1896, 2017