Lubianca Neto José Faibes, Koerig Schuster Artur, Neves Lubianca João Pedro, Eavey Roland Douglas
Medical School of Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
Graduate Program in Pediatrics of Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
OTO Open. 2022 Jul 8;6(3):2473974X221108935. doi: 10.1177/2473974X221108935. eCollection 2022 Jul-Sep.
To systematically review the results of inlay cartilage butterfly tympanoplasty and standard underlay temporal fascia tympanoplasty for anatomic and functional end points.
PubMed, Embase, MEDLINE, and Virtual Health Library (VHL/Lilacs) databases were searched from inception through April 2, 2021. No restrictions on language, publication year, or publication status were applied.
The meta-analysis included data from articles that met inclusion criteria and were extracted by 2 authors independently. The PRISMA statement was followed. Risk of Bias 2.0 and Newcastle-Ottawa Scale were used to assess risk of bias. The primary outcome was tympanic membrane closure rate. The secondary outcome was improvement of the air-bone gap.
Ten studies were included, 9 cohort studies and 1 randomized clinical trial, with 577 patients. The graft take rate was 82.8% in the butterfly cartilage inlay tympanoplasty group and 85.2% in the temporal fascia underlay tympanoplasty group (relative risk, 1.01; 95% CI, 0.93-1.11; = 42%, = .08). The air-bone gap reduction ranged from 6.1 to 11.28 in the butterfly cartilage inlay group and from 5.2 to 12.66 in the temporal fascia underlay group, with a mean difference between groups of -2.08 (95% CI, -3.23 to -0.94; = 58%, = .04), favoring temporal fascia underlay.
The 2 tympanoplasty techniques analyzed here produced similar results in terms of successful reconstruction of the tympanic membrane and reduction in the air-bone gap. Neither age nor follow-up length of time influenced outcomes.
系统评价嵌体软骨蝴蝶鼓膜成形术和标准的颞肌筋膜内置法鼓膜成形术在解剖学和功能终点方面的结果。
检索了PubMed、Embase、MEDLINE和虚拟健康图书馆（VHL/Lilacs）数据库，检索时间从建库至2021年4月2日。对语言、出版年份或出版状态没有限制。
荟萃分析纳入了符合纳入标准的文章数据，并由2位作者独立提取。遵循PRISMA声明。使用偏倚风险2.0和纽卡斯尔-渥太华量表评估偏倚风险。主要结局是鼓膜封闭率。次要结局是气骨导差的改善情况。
纳入10项研究，9项队列研究和1项随机临床试验，共577例患者。蝴蝶软骨嵌体鼓膜成形术组的移植物成活率为82.8%，颞肌筋膜内置法鼓膜成形术组为85.2%（相对危险度，1.01；95%可信区间，0.93-1.11；I² = 42%，P = 0.08）。蝴蝶软骨嵌体组的气骨导差缩小范围为6.1至11.28，颞肌筋膜内置法组为5.2至12.66，两组间平均差值为-2.08（95%可信区间，-3.23至-0.94；I² = 58%，P = 0.04），支持颞肌筋膜内置法。
本文分析的两种鼓膜成形术在鼓膜成功重建和气骨导差缩小方面产生了相似的结果。年龄和随访时间长短均未影响结局。
