■系统回顾镶嵌软骨蝶形鼓室成形术和标准颞下筋膜鼓室成形术的解剖和功能终点的结果。
■PubMed,Embase,MEDLINE,和虚拟健康图书馆(VHL/紫丁香)数据库从开始到2021年4月2日进行搜索。语言没有限制,出版年份,或应用了发布状态。
■荟萃分析包括来自符合纳入标准的文章的数据,并由2位作者独立提取。PRISMA声明得到了遵循。偏倚风险2.0和纽卡斯尔-渥太华量表用于评估偏倚风险。主要结果是鼓膜闭合率。次要结果是改善了气-骨间隙。
■纳入了10项研究,9项队列研究和1项随机临床试验,577名患者蝶形软骨嵌体鼓室成形术组的移植物取出率为82.8%,颞筋膜下鼓室成形术组为85.2%(相对风险,1.01;95%CI,0.93-1.11;I2=42%,P=.08)。蝶形软骨嵌体组气-骨间隙减少6.1~11.28,颞筋膜下垫组5.2~12.66,组间的平均差异为-2.08(95%CI,-3.23至-0.94;I2=58%,P=.04),有利于颞筋膜底层。
■此处分析的2鼓室成形术技术在成功重建鼓膜和减少气-骨间隙方面产生了类似的结果。年龄和随访时间长短均不影响结果。
UNASSIGNED: To systematically review the results of inlay cartilage butterfly tympanoplasty and standard
underlay temporal fascia tympanoplasty for anatomic and functional end points.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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; I 2 = 42%, P = .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; I 2 = 58%, P = .04), favoring temporal fascia
underlay.
UNASSIGNED: 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.