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Endoscopic versus microscopic stapes surgery outcomes: A meta‐analysis and systematic review
Author(s) -
Koukkoullis Alexandros,
Tóth István,
Gede Noémi,
Szakács Zsolt,
Hegyi Péter,
Varga Gábor,
Pap István,
Harmat Kinga,
Németh Adrienn,
Szanyi István,
Lujber László,
Gerlinger Imre,
Révész Péter
Publication year - 2020
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.28353
Subject(s) - medicine , confidence interval , meta analysis , stapes , strictly standardized mean difference , funnel plot , surgery , odds ratio , perforation , publication bias , middle ear , materials science , punching , metallurgy
Objective Compare intraoperative and postoperative outcomes of endoscopic and microscopic stapes surgery to provide objective evidence on whether the former is a better alternative than the latter. Methods We performed a systematic review and meta‐analysis for studies that compared endoscopic stapes surgery with microscopic stapes surgery. Only studies that met predetermined criteria were selected and assessed for bias and quality. Primary outcomes were postoperative air–bone gap (ABG) and chorda tympani nerve injury. Secondary outcomes were average operating time, tympanic membrane (TM) perforation, and postoperative taste disturbance, pain, and dizziness. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean difference (WMD) with 95% CI for continuous outcomes. A confidence interval starting above 1.0 was considered as statistically significant. I 2 and χ 2 tests were used to quantify statistical heterogeneity. We used funnel plots to look for publication bias and performed a sensitivity analysis. Results Six nonrandomized cohort studies were eligible. The primary outcomes were ABG < 10 dB: OR = 1.80 (95% CI: 0.96 to 3.38), ABG = 11 dB to 20 dB: OR = 1.49 (95% CI: 0.76 to 2.93), ABG > 20 dB: OR = 2.51 (95% CI: 0.77 to 8.22), and chorda tympani injury: OR = 3.51 (95% CI: 1.55 to 7.93). Secondary outcomes were taste: OR = 2.36 (95% CI: 1.01 to 5.51), average operation time: WMD = 0.14 (95% CI: −11.69 to 11.98), TM perforation: OR = 1.70 (95% CI: 0.44 to 6.58); pain: OR = 0.84 (95% CI: 0.36 to 1.96), and dizziness: OR = 2.15 (95% CI: 0.94 to 4.89). Conclusions Endoscopic stapes surgery is a valid alternative to the microscope. Level of Evidence 2a Laryngoscope , 130: 2019–2027, 2020