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Meta-Analysis
. 2024 May;281(5):2243-2252.
doi: 10.1007/s00405-023-08305-1. Epub 2023 Nov 15.

Comparison of endoscope-assisted and microscope-assisted type I tympanoplasty; a systematic review and meta-analysis

Kirolos Botros Elnahal  1 , Mohamed Amir Hassan  2 , Ahmed Mahmoud Maarouf  2
Affiliations
Meta-Analysis

Comparison of endoscope-assisted and microscope-assisted type I tympanoplasty; a systematic review and meta-analysis

Kirolos Botros Elnahal et al. Eur Arch Otorhinolaryngol. 2024 May.

Abstract

Objectives: To analyze and compare the available data about the outcomes of endoscopic and microscopic type I tympanoplasty.

Data sources: PubMed, Cochrane library Ovid, Scopus, Google scholar, and ClinicalTrials.

Methods: We conducted a meta-analysis in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We included comparative studies describing type I tympanoplasty, and comparing surgical outcomes of the endoscope with the microscope in terms of efficacy and safety.

Results: Our systematic search yielded 22 studies meeting the inclusion criteria and eligible for analysis. The pooled graft uptake rates and audiological results of endoscopic and microscopic tympanoplasty demonstrated non-significant differences. In contrast, endoscopic type I tympanoplasty outperforms microscopic tympanoplasty regarding a highly significant decrease not only in pooled mean operative time but also in the pooled complications rate.

Conclusions: Based on our meta-analysis, the surgical outcomes of endoscope-assisted and microscope-assisted type I tympanoplasty in terms of postoperative hearing outcomes and the graft uptake rate were comparable. On the contrary, operative time and complications rate proved to be significantly reduced with endoscopy compared to microscopy. Hence, the endoscope is as efficient as the microscope in type I tympanoplasty but less invasive, fewer in complications and shorter in operative time.

Keywords: Endoscope; Meta-analysis; Microscope; Myringoplasty; Tympanic membrane perforation; Tympanoplasty.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for study selection
Fig. 2
Fig. 2
A Forest plot comparing the operative time of endoscopic tympanoplasty and microscopic tympanoplasty. B Funnel plot of the operative time. CI confidence interval; IV inverse variance; SE standard error; SMD standardized mean difference
Fig. 3
Fig. 3
A Forest plot comparing the air-bone gaps improvement of both techniques. B Funnel plot of the air-bone gaps improvement. CI confidence interval; IV inverse variance; SE standard error; SMD standardized mean difference
Fig. 4
Fig. 4
A Forest plot comparing the graft uptake rate of endoscopic tympanoplasty and microscopic tympanoplasty. B Funnel plot of the graft uptake rate. CI confidence interval; M–H Mantel–Haenszel; OR odds ratio; SE standard error
Fig. 5
Fig. 5
Forest plot comparing the postoperative complications rate of endoscopic tympanoplasty and microscopic tympanoplasty with regard to infection (wet ear), wound gap, visible scar, nausea and vomiting. CI confidence interval; M–H Mantel–Haenszel
See this image and copyright information in PMC

References

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