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内镜或显微镜下鼓室成形术的优缺点:理论领域的系统评价

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review.

作者信息

Bianchini Ana Júlia, Berlitz Vitória Gabriela, Mocelin Aurenzo Gonçalves, Ribeiro Juliana Ferraz, Keruk João Gabriel, Hamerschmidt Rogério

机构信息

Otorhinolaryngology Department, Universidade Federal do Paraná, Alto da Glória, Curitiba, PR, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2022 Jul 13;27(3):e528-e535. doi: 10.1055/s-0042-1748808. eCollection 2023 Jul.

DOI:10.1055/s-0042-1748808
PMID:37564466
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10411212/
Abstract

Tympanoplasty is a reparative surgery that has multiple indications. The aid of a microscope or an endoscope is necessary to carry out the procedure. The classic method utilizes the microscope; however, in the recent decades, the endoscope has been popular. Although many articles try to compare these two techniques, there is still no robust evidence that confirms the superiority of either technique. In the present work, we seek to perform a systematic review contribute with this.  The present systematic review attempted to compare endoscopic and microscopic surgery techniques and to discover whether there would be superiority in the results of any of them, based on data currently available in the literature.  The objectives of the present review were organized according to the PICO planning and strategy adapted for systematic reviews. The inclusion and exclusion criteria were established aiming to select only select primary data. The main medical databases were searched using an optimized search string with appropriate descriptors. The searched databases were MEDLINE, LILACS, SciELO, and EMBASE. A total of 99 studies were selected and 38 were fully assessed after the inclusion criteria were applied. All included articles were reviewed by all authors and their results were discussed and summarized.  The endoscopic technique was shown to be a safer technique comparable in effectiveness to the use of microscopy. In addition, it provides possible advantages such as shortening the surgical time and better postoperative pain outcomes.

摘要

鼓室成形术是一种具有多种适应症的修复性手术。进行该手术需要显微镜或内窥镜的辅助。经典方法使用显微镜;然而,在最近几十年中,内窥镜已变得流行。尽管许多文章试图比较这两种技术,但仍然没有确凿的证据证实哪种技术更具优势。在本研究中,我们试图进行一项系统评价以对此做出贡献。

本系统评价试图比较内窥镜手术技术和显微镜手术技术,并根据目前文献中的数据发现它们的结果是否存在优势。

本综述的目标是根据适用于系统评价的PICO计划和策略进行组织的。制定了纳入和排除标准,旨在仅选择原始数据。使用带有适当描述符的优化搜索字符串搜索主要医学数据库。搜索的数据库包括MEDLINE、LILACS、SciELO和EMBASE。总共选择了99项研究,在应用纳入标准后对其中38项进行了全面评估。所有纳入的文章均由所有作者进行了审查,并对其结果进行了讨论和总结。

结果表明,内窥镜技术是一种更安全的技术,其有效性与显微镜相当。此外,它还具有可能的优势,如缩短手术时间和改善术后疼痛情况。

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2
Ossicular chain reconstruction: endoscopic or microscopic?听骨链重建:内镜下还是显微镜下?
J Laryngol Otol. 2020 Dec;134(12):1108-1114. doi: 10.1017/S0022215120002728. Epub 2021 Jan 7.
3
Comparative study of endoscopic and microscopic tympanoplasty performed by a single experienced surgeon.
印度中部一家三级护理医院中内镜经耳道鼓室成形术与传统耳后入路鼓室成形术的对比研究
Cureus. 2024 Aug 17;16(8):e67081. doi: 10.7759/cureus.67081. eCollection 2024 Aug.
单一经验丰富的外科医生行内镜与显微镜下鼓膜成形术的对比研究。
Am J Otolaryngol. 2021 Jan-Feb;42(1):102788. doi: 10.1016/j.amjoto.2020.102788. Epub 2020 Oct 23.
4
A comparison of endoscopic and microscopic inlay butterfly cartilage tympanoplasties and their educational utility.内镜与显微镜下蝶骨软骨嵌入式鼓室成形术的比较及其教学实用性。
PLoS One. 2020 Oct 30;15(10):e0241152. doi: 10.1371/journal.pone.0241152. eCollection 2020.
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Endoscopic versus microscopic type-I cartilage tympanoplasty for anterior perforation - a comparative study.内镜下与显微镜下Ⅰ型软骨鼓膜成形术治疗鼓膜前部穿孔的比较研究
Acta Otolaryngol. 2021 Feb;141(2):135-140. doi: 10.1080/00016489.2020.1834616. Epub 2020 Oct 29.
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Comparison of clinical outcome between endoscopic and postauricular incision microscopic type-1 tympanoplasty.内镜下与耳后切口显微镜下Ⅰ型鼓室成形术临床疗效比较。
Acta Otolaryngol. 2021 Jan;141(1):29-33. doi: 10.1080/00016489.2020.1821091. Epub 2020 Oct 6.
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Comparative Study of Endoscopic and Microscopic Type I Tympanoplasty in Terms of Delayed Facial Palsy.内镜与显微镜下 I 型鼓室成形术治疗迟发性面瘫的对比研究。
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