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Meta-Analysis
. 2021 Sep;131(9):E2583-E2591.
doi: 10.1002/lary.29609. Epub 2021 May 18.

Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

Liam Simani  1 , Shahaf Shilo  1 , Yahav Oron  1 , Rani A Eta  1 , Ophir Handzel  1 , Nidal Muhanna  1 , Anton Warshavsky  1 , Gilad Horowitz  1 , Omer J Ungar  1
Affiliations
Meta-Analysis

Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

Liam Simani et al. Laryngoscope. 2021 Sep.

Abstract

Objectives/hypothesis: To investigate the risk of residual tympanic membrane (TM) perforation after intratympanic (IT) steroidal treatment administered via transtympanic injection compared with trans-tympanostomy tube (TyT).

Study design: Case series, systematic review and meta analysis.

Methods: Data were retrieved from the medical files of an original cohort of all consecutive patients with sudden sensorineural hearing loss necessitating IT steroidal treatment in a tertiary medical center between January 1, 2016 and November 20, 2020. A systematic literature search of "MEDLINE" via "PubMed," "Embase," and "Web of Science" on comparable published cases was performed and meta-analysis was established.

Results: Eighteen studies describing 818 ears were included in the quantitative meta-analysis in addition to a local cohort of 140 ears. The proportion of residual TM perforation was 1.11% and 1.14% (95% confidence interval: 0.01%-3.27% and 0.028%-2.38%) in the TyT and trans-tympanic groups, respectively, suggesting no significant difference in residual TM perforation risk between these techniques.

Conclusion: IT steroid therapy via trans-TyT is not associated with more residual perforations than IT steroid therapy via transtympanic injections.

Level of evidence: NA Laryngoscope, 131:E2583-E2591, 2021.

Keywords: Tympanostomy tube; intratympanic steroids; residual perforation; sudden sensorineural hearing loss; tympanic membrane perforation.

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