Abstract：
OBJECTIVE: To compare postoperative tympanoplasty outcomes between active versus inactive otitis media (OM) patients with tympanic membrane perforation.
UNASSIGNED: Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023.
METHODS: Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake.
RESULTS: Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, -0.76 dB; 95% CI, -2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34-1.09; p = 0.10, moderate certainty) have an overall p value >0.05.
CONCLUSIONS: There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients\' preoperative ear discharge status.
UNASSIGNED: Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023.
METHODS: Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake.
RESULTS: Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, -0.76 dB; 95% CI, -2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34-1.09; p = 0.10, moderate certainty) have an overall p value >0.05.
CONCLUSIONS: There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients\' preoperative ear discharge status.
摘要：
■
目的：比较鼓膜穿孔的活动性和非活动性中耳炎（OM）患者术后鼓室成形术的结果。
■Medline通过PubMed，Embase,WebofScience,Cochrane中央控制试验登记册,和谷歌学者发表的研究从成立到2023年3月1日。
方法：包括对15至60岁的患者进行显微镜/内窥镜下鼓膜成形术的研究，这些患者使用了覆盖/覆盖技术，并报告了术后平均听力增益和移植物摄取。需要同时进行外科手术的研究，报告有合并症和非英语全文文章的患者被排除.文章由两名研究人员独立筛选，并根据MicrosoftExcel中的预定形式提取数据。Cochrane偏倚风险评估用于随机研究的偏倚风险评估和非随机干预研究的偏倚风险评估。使用逆方差随机效应模型计算平均听力增益的平均差和相应的95％置信区间（CI）以及移植物摄取的DerSimonian和Laird随机效应模型，将类似的研究汇总用于荟萃分析。
结果：由2,373名患者组成的33项研究符合纳入/排除标准，将7例纳入荟萃分析.纳入的文章显示，与活动OM患者相比，非活动OM患者的平均术后平均听力增益较高，为10.84dB，移植物摄取为88.7％（9.15dB和84.2％）。平均听力增益的荟萃分析(MD，-0.76dB；95%CI，-2.11至0.60；p=0.27，中等确定性）和移植物摄取（OD，0.61;95%CI,0.34-1.09;p=0.10,中度确定性)总体p值>0.05。
结论：接受鼓室成形术的活动期和非活动期OM患者在术后平均听力增益和移植物摄取方面无统计学差异。因此，鼓室成形术不应仅仅因为患者术前耳廓放电状态而推迟。
目的：比较鼓膜穿孔的活动性和非活动性中耳炎（OM）患者术后鼓室成形术的结果。
■Medline通过PubMed，Embase,WebofScience,Cochrane中央控制试验登记册,和谷歌学者发表的研究从成立到2023年3月1日。
方法：包括对15至60岁的患者进行显微镜/内窥镜下鼓膜成形术的研究，这些患者使用了覆盖/覆盖技术，并报告了术后平均听力增益和移植物摄取。需要同时进行外科手术的研究，报告有合并症和非英语全文文章的患者被排除.文章由两名研究人员独立筛选，并根据MicrosoftExcel中的预定形式提取数据。Cochrane偏倚风险评估用于随机研究的偏倚风险评估和非随机干预研究的偏倚风险评估。使用逆方差随机效应模型计算平均听力增益的平均差和相应的95％置信区间（CI）以及移植物摄取的DerSimonian和Laird随机效应模型，将类似的研究汇总用于荟萃分析。
结果：由2,373名患者组成的33项研究符合纳入/排除标准，将7例纳入荟萃分析.纳入的文章显示，与活动OM患者相比，非活动OM患者的平均术后平均听力增益较高，为10.84dB，移植物摄取为88.7％（9.15dB和84.2％）。平均听力增益的荟萃分析(MD，-0.76dB；95%CI，-2.11至0.60；p=0.27，中等确定性）和移植物摄取（OD，0.61;95%CI,0.34-1.09;p=0.10,中度确定性)总体p值>0.05。
结论：接受鼓室成形术的活动期和非活动期OM患者在术后平均听力增益和移植物摄取方面无统计学差异。因此，鼓室成形术不应仅仅因为患者术前耳廓放电状态而推迟。
