Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.
School of Medicine, Ningbo University, Ningbo, Zhejiang, China.
Ear Nose Throat J. 2023 Jul;102(7):NP369-NP378. doi: 10.1177/01455613211015439. Epub 2021 May 31.
To compare the effectiveness of butterfly cartilage tympanoplasty (BCT) with that of conventional surgical approaches in the treatment of tympanic membrane perforations.
A systematic search was performed by screening the PubMed, Embase, and Cochrane Library databases up to October 31, 2020. Two coauthors independently identified studies in accordance with the selection criteria. Data were pooled and analyzed via Review Manager version 5.3 and Stata version 12.0 software. The postoperative outcomes were measured and expressed as odds ratios (ORs) and standardized mean differences (SMDs). Additionally, heterogeneity was assessed through the statistic.
A total of 15 articles were eligible for final inclusion. The OR values for the graft uptake rate, compared to conventional tympanoplasty, were 1.12 (95%CI: 0.56-2.22, = 52%, = .75) and 1.22 (95%CI: 0.58-2.59, = 0%, = .60), and the OR compared to fat plug myringoplasty was 3.02 (95%CI: 1.04-8.77, = 0%, = .04). The qualitative analysis of the hearing results reflected significant postoperative auditory gains with no significant differences between the BCT and control groups, indicating satisfactory and similar postoperative hearing improvement. Moreover, the operation time was shortened (SMD = -2.19, 95%CI: -2.79 to -1.59, = 82%, < .05), and the postoperative pain was less with the BCT approach.
Butterfly cartilage tympanoplasty has satisfactory efficacy in terms of anatomical and functional results in small to medium perforations. It reduces operation time and postoperative pain. However, the effectiveness on large perforation requires further assessment by well-designed studies.
比较蝶形软骨鼓膜成形术（BCT）与传统手术方法治疗鼓膜穿孔的疗效。
通过筛选 PubMed、Embase 和 Cochrane Library 数据库，对截至 2020 年 10 月 31 日的文献进行系统搜索。两位合著者根据选择标准独立识别研究。使用 Review Manager 版本 5.3 和 Stata 版本 12.0 软件对数据进行汇总和分析。术后结果以比值比（OR）和标准化均数差（SMD）表示。此外，通过 统计评估异质性。
共有 15 篇文章符合最终纳入标准。与传统鼓膜成形术相比，移植吸收率的 OR 值分别为 1.12（95%CI：0.56-2.22， = 52%， =.75）和 1.22（95%CI：0.58-2.59， = 0%， =.60），与脂肪栓子鼓膜成形术相比的 OR 值为 3.02（95%CI：1.04-8.77， = 0%， =.04）。听力结果的定性分析表明，术后听力有明显提高，但 BCT 组与对照组之间无显著差异，表明术后听力改善令人满意且相似。此外，BCT 缩短了手术时间（SMD = -2.19，95%CI：-2.79 至-1.59， = 82%， <.05），并减少了术后疼痛。
在小至中等穿孔中，蝶形软骨鼓膜成形术在解剖学和功能结果方面具有令人满意的疗效。它缩短了手术时间并减轻了术后疼痛。然而，对于大穿孔的有效性需要进一步通过精心设计的研究进行评估。
