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Meta‐analysis does not support routine traditional nuclear medicine studies for malignant otitis
Author(s) -
Moss Wiliam James,
Finegersh Andrey,
Narayanan Ajay,
Chan Jason Ying Kuen
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.28411
Subject(s) - meta analysis , medicine , cochrane library , medline , web of science , otitis , modalities , systematic review , medical physics , surgery , social science , sociology , political science , law
Objectives The role of traditional nuclear medicine studies in the management of malignant otitis externa (MOE) is unclear and there are ongoing debates regarding their diagnostic value. The authors perform a systematic review and meta‐analysis to assess the sensitivity and specificity of traditional nuclear medicine studies in the diagnosis of MOE. Methods In accordance with PRISMA guidelines, a query of the Medline, Embase, Web of Science, and Cochrane databases was undertaken. The primary outcomes of interest were the sensitivity and specificity of traditional nuclear medicine studies to detect MOE. Results Of the initial 1317 hits from the four databases, 20 articles with a combined 608 patients were ultimately included in the review. The pooled sensitivities for Technetium‐99 and Gallium‐67 were 85.1% (95% CI, 72.0–98.1%) and 71.2% (95% CI, 55.1–87.3%) respectively. The available evidence suggested poor specificity of these modalities, but was insufficient for meta‐analysis. Neither modality was shown to be effective in the assessment of disease resolution. Conclusion The sensitivities of Technetium‐99 and Gallium‐67 to detect MOE are less favorable than was initially thought. Given this finding and their poor specificity, lack of anatomic resolution, unproven ability to detect disease resolution and variable availability, this review does not support the routine use of these studies in the management of MOE. Level of Evidence N/A Laryngoscope , 130:1812–1816, 2020