Albazee Ebraheem, Alajmi Hamad, Aldoukhi Ali, Alali Abeer Waleed
Otorhinolaryngology-Head and Neck Surgery, Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait.
Department of Otolaryngology-Head and Neck Surgery, Jaber Al-Ahmed Hospital, Kuwait City, Kuwait.
Otolaryngol Head Neck Surg. 2025 Apr;172(4):1164-1176. doi: 10.1002/ohn.1109. Epub 2025 Jan 3.
To compare the safety and efficacy of endoscopic versus microscopic stapedotomy in patients with otosclerosis.
PubMed, Embase, Web of Science, Scopus, Google Scholar, and CENTRAL.
Eligible randomized controlled trials (RCTs) were assessed for bias using Cochrane's instrument. The specific outcomes included the mean duration of surgery, the mean gain in air-bone gap (ABG), and the rates of chorda tympani nerve (CTN) injury, CTN manipulation, facial nerve (FN) injury, tympanic membrane (TM) perforation, dysgeusia, dizziness, and pain score. Continuous data were analyzed using mean difference (MD) or standardized mean difference (SMD), and dichotomous data with risk ratio (RR), with 95% confidence intervals (CIs).
Eleven RCTs with 515 patients were analyzed. There was no significant difference between both groups in the mean duration of surgery (MD = -10.42, 95% CI [-26.26, 5.43]), mean gain in ABG (MD = 1.04, 95% CI [-0.48, 2.57]), CTN injury (RR = 0.46, 95% CI [0.20, 1.04]), FN injury (RR = 1.00, 95% CI [0.11, 9.27]), TM perforation (RR = 0.99, 95% CI [0.23, 4.25]), and dizziness (RR = 0.79, 95% CI [0.41, 1.53]). However, endoscopic stapedotomy significantly reduced the need for CTN manipulation (RR = 0.58, 95% CI [0.35, 0.96]), dysgeusia (RR = 0.33, 95% CI [0.19, 0.57]), and pain score (SMD = -1.59, 95% CI [-2.22, -0.97]).
Endoscopic stapedotomy significantly reduces dysgeusia, CTN manipulation, and pain compared to microscopic stapedotomy, with similar surgery durations, audiometric gains, and comparable risks of CTN injury, TM perforation, FN injury, and dizziness.
比较耳硬化症患者行内镜下镫骨手术与显微镜下镫骨手术的安全性和疗效。
PubMed、Embase、Web of Science、Scopus、谷歌学术和CENTRAL。
采用Cochrane工具评估纳入的随机对照试验（RCT）的偏倚。具体结局包括平均手术时长、气骨导间距（ABG）平均改善值、鼓索神经（CTN）损伤率、CTN操作率、面神经（FN）损伤率、鼓膜（TM）穿孔率、味觉障碍、头晕及疼痛评分。连续数据采用均数差（MD）或标准化均数差（SMD）分析，二分数据采用风险比（RR）分析，并给出95%置信区间（CI）。
分析了11项包含515例患者的RCT。两组在平均手术时长（MD = -10.42，95%CI[-26.26, 5.43]）、ABG平均改善值（MD = 1.04，95%CI[-0.48, 2.57]）、CTN损伤（RR = 0.46，95%CI[0.20, 1.04]）、FN损伤（RR = 1.00，95%CI[0.11, 9.27]）、TM穿孔（RR = 0.99，95%CI[0.23, 4.
