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内镜与显微镜下鼓室成形术治疗慢性中耳炎的系统评价。

Endoscopic versus microscopic ossiculoplasty in chronic otitis media: a systematic review of the literature.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.

Department of Otorhinolaryngology, Head and Neck Surgery, Royal Hallamshire Hospital, Sheffield, UK.

出版信息

Eur Arch Otorhinolaryngol. 2021 Apr;278(4):917-923. doi: 10.1007/s00405-020-06182-6. Epub 2020 Jul 7.

Abstract

OBJECTIVE

The aim of this study was to compare the endoscopic and microscopic ossiculoplasty in patients with chronic otitis media.

METHODS

MEDLINE, ScienceDirect, and the Cochrane Library databases as well as other sources were searched by two independent reviewers. Controlled studies comparing endoscopic and microscopic ossiculoplasty in patients with chronic otitis media were included. Mean air-bone gap closure was the primary outcome. Secondary outcomes were operation time and complications.

RESULTS

Three studies met the inclusion criteria. No statistically significant differences in audiometric outcomes between endoscopic and microscopic groups in all three included studies were reported. Although endoscopic technique was related to a fewer number of postoperative complications and a shorter operation time, these outcomes did not reach statistical significance.

CONCLUSION

Endoscopic ossiculoplasty is associated with similar postoperative hearing results compared to the traditional microscopic approach. A trend towards a shorter operative time and reduced morbidity for the endoscopic approach has been observed, but well-designed randomized controlled trials are warranted to confirm this finding.

摘要

目的

本研究旨在比较慢性中耳炎患者内镜下和显微镜下的听骨链成形术。

方法

两位独立的审查员检索了 MEDLINE、ScienceDirect 和 Cochrane 图书馆数据库以及其他来源。纳入了比较慢性中耳炎患者内镜下和显微镜下听骨链成形术的对照研究。主要结局为气骨导差的平均闭合。次要结局为手术时间和并发症。

结果

符合纳入标准的研究有 3 项。所有纳入的研究均未报道内镜组和显微镜组在听力结果方面存在统计学显著差异。尽管内镜技术与术后并发症较少和手术时间较短相关,但这些结果并未达到统计学意义。

结论

与传统的显微镜方法相比,内镜下听骨链成形术具有相似的术后听力效果。观察到内镜方法的手术时间更短、发病率更低的趋势,但需要进行精心设计的随机对照试验来证实这一发现。

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