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一项关于外耳道闭锁成形术相关长期听力结果及并发症的荟萃分析。

A meta-analysis of the long-term hearing outcomes and complications associated with atresiaplasty.

作者信息

Li Chen-Long, Dai Pei-Dong, Yang Lin, Zhang Tian-Yu

机构信息

Department of Otolaryngology - Head and Neck Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.

Research Center, Eye & ENT Hospital, Fudan University, Shanghai, China; Hearing Medicine Key Laboratory, National Ministry of Public Health, Shanghai, China.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 Jun;79(6):793-797. doi: 10.1016/j.ijporl.2015.03.032. Epub 2015 Apr 9.

Abstract

OBJECTIVE

To summarize peer-reviewed literature to evaluate the stability of long-term hearing outcomes with prolonged follow-up, and describe the incidence of complications related to atresiaplasty.

DESIGN

A literature search of EMBASE, MEDLINE, PubMed, Google Scholar, and Web of Science was performed to identify studies of congenital aural atresia (CAA).

STUDY SAMPLE

Selected studies were published between 1997 and 2014. The 19 studies covered 964 CAA ears.

RESULTS

Stenosis and bony regrowth occurred in 14.2% (range from 0% to 30.3%). Lateralization of tympanic membrane (TM) occurred in 7.5% (range from 0% to 18.2%). Facial nerve palsy occurred in 0.5% (range from 0% to 5.0%). Six studies used Air-bone Gap (ABG) to evaluate the short-term and long-term hearing outcomes. The hearing outcomes were performed using meta-analysis, there was no significantly heterogeneity (I(2) = 0%, p = 0.997), and there was a degradation of hearing outcomes with prolonged follow-up (RR = 1.13, 95%CI: 0.98-1.30).

CONCLUSION

Nearly all studies focus on postoperative stenosis and bony regrowth, but some studies neglect lateralization of TM. Based on available data, which shows a lack of major complications, such as facial nerve palsy, atresiaplasty is a safe procedure. Our meta-analysis indicated that there was a degradation of hearing outcomes with prolonged follow-up.

摘要

目的

总结经同行评审的文献,以评估长期随访时听力结果的稳定性,并描述与外耳道成形术相关的并发症发生率。

设计

对EMBASE、MEDLINE、PubMed、谷歌学术和科学网进行文献检索,以确定先天性耳道闭锁(CAA)的研究。

研究样本

所选研究发表于1997年至2014年之间。这19项研究涵盖了964只CAA耳朵。

结果

狭窄和骨质再生发生率为14.2%(范围为0%至30.3%)。鼓膜(TM)外移发生率为7.5%(范围为0%至18.2%)。面神经麻痹发生率为0.5%(范围为0%至5.0%)。六项研究使用气骨导差(ABG)评估短期和长期听力结果。对听力结果进行荟萃分析,无显著异质性(I(2)=0%,p = 0.997),且随着随访时间延长听力结果有所下降(RR = 1.13,95%CI:0.98 - 1.30)。

结论

几乎所有研究都关注术后狭窄和骨质再生,但一些研究忽略了TM外移。基于现有数据显示缺乏诸如面神经麻痹等主要并发症,外耳道成形术是一种安全的手术。我们的荟萃分析表明,随着随访时间延长听力结果有所下降。

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