| Abstrakt: |
Purpose: To compare the effectiveness of endoscopic and microscopic approaches for butterfly cartilage graft inlay tympanoplasty regarding anatomical and hearing outcomes through a systematic review and meta-analysis. Methods: A search of PubMed, Embase, MEDLINE and Virtual Health Library was performed from inception to July 3rd, 2021, using keywords such as tympanoplasty, cartilage graft and inlay technique. Data from articles that met inclusion criteria were extracted by two authors independently. The PRISMA statement was followed. RoB2 and ROBINS-I tools 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. Results: Five studies were included, one randomized clinical trial and four retrospective cohorts, with a total of 318 patients were included. Graft take rate was 91.3% in the endoscope group and 93.6% in the microscope group (RR 0.98; 95% CI, 0.93-1.03; I2 0%; P = 0.68). Four studies provided data about the secondary outcome, all showing significant reductions in air-bone gap, ranging from 5.7 to 11.0 in the endoscope group and from 5.8 to 11.6 in the microscope group, with a mean difference between groups of 0.85 (95% CI, -0.79-2.48). Conclusion: Although the overall evidence of the included studies was low, endoscopic and microscopic butterfly cartilage graft inlay tympanoplasty have similar results on anatomical and hearing outcomes, making the choice between such approaches an individual choice for the surgeon. [ABSTRACT FROM AUTHOR] |
