目的:对所有随机对照试验(RCT)进行系统评价和荟萃分析,这些试验检查了干与湿颞肌筋膜移植在I型鼓室成形术患者中的疗效。
方法:WebofScience,Scopus,PubMed,和CENTRAL数据库从开始到2022年7月进行筛选。使用Cochrane偏倚风险工具评估纳入随机对照试验的质量。在随机效应模型中,将结果总结为风险比(RR)或平均差(MD)和95%置信区间(CI)。
结果:共纳入8个RCTs,989例患者(干组=514,湿组=475)。整体质量很低,\'一些担忧\',和“高风险”中的五个,两个,和一个RCT(s),分别。两组之间的手术成功率没有显着差异(n=8个随机对照试验,RR0.99,95%CI[0.95,1.03],p=0.6),听力学成功率(n=5个随机对照试验,RR=0.93,95%CI[0.73,1.13],p=0.48),纯音平均平均差(n=2个随机对照试验,MD=2.73Hz,95%CI[-2.31,7.77],p=0.29),和移植物放置时间的平均差异(n=3个随机对照试验,MD=-2.18分钟,95%CI[-5.11,0.76],p=0.15)。然而,与干颞肌筋膜组相比,手术时间的平均差异显着降低,有利于湿润(n=2RCT,MD=2.95min,95%CI[-1.80,4.11],p<0.001)。根据鼓膜穿孔的大小和部位,两组之间的手术成功率没有显着差异。
结论:颞肌筋膜移植物的类型(干或湿)不影响I型鼓室成形术的临床结果。
OBJECTIVE: To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that examined the efficacy of dry versus wet temporalis fascia graft among patients undergoing type-I tympanoplasty.
METHODS: Web of Science, Scopus, PubMed, and CENTRAL databases were screened from inception until July 2022. The Cochrane risk of bias tool was used to assess the quality of included RCTs. The outcomes were summarized as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI) in a random-effects model.
RESULTS: Eight RCTs with 989 patients (dry group = 514 and wet group = 475) were included. The overall quality was \'low\', \'some concerns\', and \'high\' risk of bias in five, two, and one RCT(s), respectively. There were no significant differences between both groups regarding the surgical success rate (n = 8 RCTs, RR 0.99, 95% CI [0.95, 1.03], p = 0.6), audiological success rate (n = 5 RCTs, RR = 0.93, 95% CI [0.73, 1.13], p = 0.48), mean difference in pure tone average (n = 2 RCTs, MD = 2.73 Hz, 95% CI [- 2.31, 7.77], p = 0.29), and mean difference in graft placement time (n = 3 RCTs, MD = - 2.18 min, 95% CI [- 5.11, 0.76], p = 0.15). However, the mean difference in operative time was significantly lower in favor of the wet compared with the dry temporalis fascia group (n = 2 RCTs, MD = 2.95 min, 95% CI [- 1.80, 4.11], p < 0.001). The surgical success rate was not significantly different between both groups according to the tympanic membrane perforation size and site.
CONCLUSIONS: The type of temporalis fascia graft (dry or wet) did not influence the clinical outcomes of type-I tympanoplasty.