Fascia compared to one-piece composite cartilage-perichondrium grafting for tympanoplasty
Autor: | Jeroen P. M. Peters, Tanly Su, Adriana L. Smit, Linda E.T. Vissers, Wilko Grolman, Sarah A. Lyons |
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Rok vydání: | 2015 |
Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Perforation (oil well) Absolute risk reduction Fascia Cochrane Library Tympanoplasty Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis medicine Number needed to treat 030223 otorhinolaryngology business |
Zdroj: | The Laryngoscope. 126:1662-1670 |
ISSN: | 0023-852X |
DOI: | 10.1002/lary.25772 |
Popis: | OBJECTIVE: To evaluate the effectiveness of type 1 tympanoplasty with one-piece composite cartilage-perichondrium (CCP) grafts compared to temporalis fascia (TF) grafts for tympanic membrane (TM) closure and hearing improvement in adult patients with a subtotal TM perforation and chronic otitis media (COM). DATA SOURCES: PubMed, Embase, Cochrane Library. REVIEW METHODS: A systematic search was conducted. Relevance and validity of selected articles were assessed. Studies that scored moderate or high on relevance were included, and relevant data for both outcomes were extracted. For the outcome of TM closure, absolute risk differences (RD), relative risks, and number needed to treat with their respective 95% confidence intervals were calculated when possible. RESULTS: We retrieved 3,783 unique studies. Ten studies satisfied the eligibility criteria. Four studies of moderate validity showed RD ranging from 0.08 to 0.13 in favor of the CCP graft compared to the TF graft for TM closure 1 year or more postoperatively, but this was not statistically significant. Five studies of moderate to high validity showed no clinically relevant difference in hearing improvement between both intervention groups at a minimum follow-up of 3 months. The relative air-bone gap closure ranged from 5.7 to 11.5 dB in the TF group and from 8.9 to 12.7 dB in the CCP group. CONCLUSIONS: There is no evidence of superiority of one-piece CCP grafting over TF grafting in type 1 tympanoplasty regarding complete closure of a subtotal perforated TM 1 year or more postoperatively or hearing improvement at a minimum of 3 months follow-up. LEVEL OF EVIDENCE: 2A Laryngoscope, 2015. |
Databáze: | OpenAIRE |
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