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Can Endoscopic Tympanoplasty Be a Good Alternative to Microscopic Tympanoplasty? A Systematic Review and Meta-Analysis

김영호|이상연|이도영|서유주
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2019.05|Clinical and Experimental Otorhinolaryngology|제12권 제2호|pp. 145-155

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참고문헌

키워드

ReviewEndoscopesTympanoplastyMyringoplasty

초록

Although efficacies and proportions of tympanoplasty performed via endoscopic ear surgery (EES) have gradually introduced, it remains unclear whether total EES is a good alternative to microscopic ear surgery (MES). Herein, we aimed to compare therapeutic effects of EES and MES in patients receiving tympanoplasty or myringoplasty. A search of MEDLINE, PubMed, and Embase databases was conducted to compare the efficacies of EES and MES. Two investigators independently reviewed all studies and extracted data with a standardized form. We assessed risk of bias and calculated pooled odds ratio (OR) estimates with a 95% confidence interval (CI). Thirteen studies (607 EES patients and 678 MES patients) met inclusion criteria for quantitative meta-analysis. In pooled analysis, those who undergo EES have 0.99 times the OR of graft success compared to those with MES (95% CI, 0.84 to 1.16; P=0.894). In qualitative analysis, comparable hearing improvement was observed between the two groups, despite inconsistent audiometric evaluation. The air-bone gaps (ABGs) improved 2.02 dB less in EES than in MES (mean difference of improvements of ABGs, 2.02; 95% CI, –3.84 to –0.20; P=0.029); however, substantial heterogeneity and publication bias limited the integrity of this analysis. Further, EES significantly decreased canalplasty rate, wound complications, and operation time, compared to MES. Moreover, patients receiving EES reported higher cosmetic satisfaction than patients receiving MES. EES can be a good alternative to MES in terms of comparable graft success rate and hearing outcomes in patients receiving tympanoplasty or myringoplasty. Moreover, EES was less invasive, resulting in higher cosmetic satisfaction, reduced morbidity, and shorter operation time. Our results may affect decision-making and outcome prediction in cases of EES; however, confirmation is needed to clarify potential bias.

Abstract

Although efficacies and proportions of tympanoplasty performed via endoscopic ear surgery (EES) have gradually introduced, it remains unclear whether total EES is a good alternative to microscopic ear surgery (MES). Herein, we aimed to compare therapeutic effects of EES and MES in patients receiving tympanoplasty or myringoplasty. A search of MEDLINE, PubMed, and Embase databases was conducted to compare the efficacies of EES and MES. Two investigators independently reviewed all studies and extracted data with a standardized form. We assessed risk of bias and calculated pooled odds ratio (OR) estimates with a 95% confidence interval (CI). Thirteen studies (607 EES patients and 678 MES patients) met inclusion criteria for quantitative meta-analysis. In pooled analysis, those who undergo EES have 0.99 times the OR of graft success compared to those with MES (95% CI, 0.84 to 1.16; P=0.894). In qualitative analysis, comparable hearing improvement was observed between the two groups, despite inconsistent audiometric evaluation. The air-bone gaps (ABGs) improved 2.02 dB less in EES than in MES (mean difference of improvements of ABGs, 2.02; 95% CI, –3.84 to –0.20; P=0.029); however, substantial heterogeneity and publication bias limited the integrity of this analysis. Further, EES significantly decreased canalplasty rate, wound complications, and operation time, compared to MES. Moreover, patients receiving EES reported higher cosmetic satisfaction than patients receiving MES. EES can be a good alternative to MES in terms of comparable graft success rate and hearing outcomes in patients receiving tympanoplasty or myringoplasty. Moreover, EES was less invasive, resulting in higher cosmetic satisfaction, reduced morbidity, and shorter operation time. Our results may affect decision-making and outcome prediction in cases of EES; however, confirmation is needed to clarify potential bias.

참고문헌 (34)

  1. Tan HE, "Type I tympanoplasty meta-analysis : a single variable analysis", Otol Neurotol, 37(7), pp.838~846 (2016)
  2. Rizer FM, "Overlay versus underlay tympanoplasty. Part II: the study", Laryngoscope, 107(12 Pt 2), pp.26~36 (1997)
  3. Mundra RK, "Tympanoplasty in subtotal perforation with graft supported by a slice of cartilage: a study with near 100 % results", Indian J Otolaryngol Head Neck Surg, 65(Suppl 3), pp.631~635 (2013)
  4. Jumaily M, "Butterfly cartilage tympanoplasty outcomes : a single-institution experience and literature review", Am J Otolaryngol, 39(4), pp.396~400 (2018)
  5. Kozin ED, "Systematic review of outcomes following observational and operative endoscopic middle ear surgery", Laryngoscope, 125(5), pp.1205~1214 (2015)
  6. Migirov L, "Exclusive endoscopic ear surgery for acquired cholesteatoma : preliminary results", Otol Neurotol, 32(3), pp.433~436 (2011)
  7. Tarabichi M, "Endoscopic middle ear surgery", Ann Otol Rhinol Laryngol, 108(1), pp.39~46 (1999)
  8. Furukawa T, "Feasibility and advantages of transcanal endoscopic myringoplasty", Otol Neurotol, 35(4), pp.e140~5 (2014)
  9. Jyothi AC, "Endoscopic myringoplasty versus microscopic myringoplasty in tubotympanic CSOM : a comparative study of 120 cases", Indian J Otolaryngol Head Neck Surg, 69(3), pp.357~362 (2017)
  10. Plodpai Y, "The outcomes of overlay myringoplasty : endoscopic versus microscopic approach", Am J Otolaryngol, 38(5), pp.542~546 (2017)
  11. James AL, "Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome", Laryngoscope, 127(11), pp.2659~2664 (2017)
  12. Nassif N, "Tympanic membrane perforation in children: endoscopic type I tympanoplasty, a newly technique, is it worthwhile?", Int J Pediatr Otorhinolaryngol, 79(11), pp.1860~1864 (2015)
  13. Harugop AS, "A comparative study of endoscope assisted myringoplasty and micrsoscope assisted myringoplasty", Indian J Otolaryngol Head Neck Surg, 60(4), pp.298~302 (2008)
  14. Lade H, "Endoscopic vs microscopic myringoplasty : a different perspective", Eur Arch Otorhinolaryngol, 271(7), pp.1897~1902 (2014)
  15. Raj A, "Endoscopic transcanal myringoplasty : a study", Indian J Otolaryngol Head Neck Surg, 53(1), pp.47~49 (2001)
  16. Lakpathi G, "Comparative study of endoscope assisted myringoplasty and microscopic myringoplasty", Indian J Otolaryngol Head Neck Surg, 68(2), pp.185~190 (2016)
  17. Kumar M, "A comparative study of endoscopic myringoplasty vs conventional myringoplasty", Otorhinolaryngology Clinics, 7(3), pp.132~137 (2015)
  18. Dundar R, "Endoscopic versus microscopic approach to type 1 tympanoplasty in children", Int J Pediatr Otorhinolaryngol, 78(7), pp.1084~1089 (2014)
  19. Kaya I, "Endoscopic versus microscopic type 1 tympanoplasty in the same patients : a prospective randomized controlled trial", Eur Arch Otorhinolaryngol, 274(9), pp.3343~3349 (2017)
  20. Huang TY, "A comparative study of endoscopic and microscopic approach type 1 tympanoplasty for simple chronic otitis media", J Int Adv Otol, 12(1), pp.28~31 (2016)
  21. Tseng CC, "Endoscopic transcanal myringoplasty for anterior perforations of the tympanic membrane", JAMA Otolaryngol Head Neck Surg, 142(11), pp.1088~1093 (2016)
  22. Tseng CC, "Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty : a systematic review and meta-analysis", Laryngoscope, 127(8), pp.1890~1896 (2017)
  23. Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration", PLoS Med, 6(7), pp.e1000100~ (2009)
  24. Kuo CH, "Comparison of endoscopic and microscopic tympanoplasty", Eur Arch Otorhinolaryngol, 274(7), pp.2727~2732 (2017)
  25. Higgins JP, "Measuring inconsistency in meta-analyses", BMJ, 327(7414), pp.557~560 (2003)
  26. Vrabec JT, "Meta-analysis of pediatric tympanoplasty", Arch Otolaryngol Head Neck Surg, 125(5), pp.530~534 (1999)
  27. Kozin ED, "Thermal effects of endoscopy in a human temporal bone model : implications for endoscopic ear surgery", Laryngoscope, 124(8), pp.E332~9 (2014)
  28. Nardone M, "Myringoplasty in simple chronic otitis media : critical analysis of long-term results in a 1, 000-adult patient series", Otol Neurotol, 33(1), pp.48~53 (2012)
  29. Kakehata S, "Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss : early results", Otol Neurotol, 27(1), pp.14~19 (2006)
  30. Marchioni D, "Endoscopic cochlear implant procedure", Eur Arch Otorhinolaryngol, 271(5), pp.959~966 (2014)
  31. 최나연, "Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty", Clinical and Experimental Otorhinolaryngology, 10(1), pp.44~49 (2017), 대한이비인후과학회[DOI]
  32. De Zinis LO, "Double-handed endoscopic myringoplasty with a holding system in children : preliminary observations", Int J Pediatr Otorhinolaryngol, 96, pp.127~130 (2017)
  33. Nazarzadeh M, "Meta-analysis of diabetes mellitus and risk of hip fractures : small-study effect", Osteoporos Int, 27(1), pp.229~230 (2016)
  34. Rucker G, "Treatment-effect estimates adjusted for small-study effects via a limit meta-analysis", Biostatistics, 12(1), pp.122~142 (2011)

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