Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131, Salerno, Italy.
Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5521-5533. doi: 10.1007/s00405-022-07551-z. Epub 2022 Jul 20.
To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy.
A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air-bone gap (ABG) closure after surgical intervention.
Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I = 28.36%; Hedge's g = 0.04, 95% CI - 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I = 28.91%; Hedge's g = 0.00, 95% CI - 0.20 0.21).
Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
比较镫骨切开术中不同材料用于圆窗封闭的疗效和安全性特征。
根据 PRISMA 指南进行系统评价。筛选 2000 年 1 月 1 日至 2021 年 12 月发表的国际英文文献，检查比较耳硬化症或先天性镫骨固定患者行镫骨切开术时使用不同材料的研究。提取与每种材料的疗效和安全性相关的数据。主要结局测量指标为手术干预后气骨导差（ABG）的闭合情况。
共有 6 项研究纳入荟萃分析。由于所采用治疗方法的异质性，我们评估了脂肪与所有其他治疗方法的使用情况，以及明胶海绵与所有其他治疗方法的使用情况。在前一种分析（脂肪与其他治疗方法）中，我们未发现两组之间 ABG 闭合存在差异（p=0.74），结果的异质性较低（I=28.36%；Hedge's g=0.04，95%CI -0.19 0.27）；同样，我们未发现明胶海绵与其他治疗方法之间存在差异（p=0.97），结果的异质性较低（I=28.91%；Hedge's g=0.00，95%CI -0.20 0.21）。
在镫骨切开术中，有多种材料可用于圆窗封闭，具有可接受的安全性和有效性。根据目前的数据，无法明确推荐选择一种材料而不是另一种材料，并且密封比不密封更方便。
