Type I Tympanoplasty: surgical success and prognostic factors

Salvador, Pedro; Gomes, Patrícia; Silva, Francisco; Fonseca, Rui

doi:10.1016/j.otoeng.2020.04.006

Cited by 2 publications

(11 citation statements)

References 21 publications

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“…Regarding the size of the perforation, we found a significant and strong correlation after analysing 13 studies' data [21,22,25,26,32,34,46,49,[54][55][56][57][58]. If the size of the perforation is larger than 50% of the tympanic membrane, it is thought to decrease the odds of success (Fig.…”

Section: Size Of the Perforationmentioning

confidence: 94%

“…Although the result was not considered significant with low number of included patients, there was a detectable effect. One of the three studies had an overall OR over one with a wide confidence interval [45], but the other two suggest that the habit of smoking negatively influences the odds of success [30,49]. In addition, previous review also pointed out, in the case of smokers the success rate may be less than in nonsmokers [60].…”

Section: Smoking Statusmentioning

confidence: 99%

“…Nine studies reported data about the condition of the opposite ear, which this could mean perforation, effusion, cholesteatoma, etc. [24,26,29,30,34,46,49,53,57]. The reason behind the pooling of the ear problem is the assumed Eustachian tube dysfunction.…”

Section: Condition Of the Opposite Earmentioning

confidence: 99%

“…Nine studies have reported data about the operated ear status [22,24,29,30,32,46,49,51,56]. The target of the comparison was the dry ear at the time of the operation vs. discharging/wet ear at the time of the operation.…”

Section: Condition Of the Operated Earmentioning

confidence: 99%

“…We performed two analyses regarding the site of the perforation, comparing marginal perforations with central ones [49,56,58] (Suppl. Fig.…”

Section: Site Of the Perforationmentioning

confidence: 99%

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Factors influencing successful reconstruction of tympanic membrane perforations: a systematic review and meta-analysis

Illés

Gergő

Keresztély

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Based on a systematic review and meta-analysis, our study aimed to provide information about the factors that influence the success of tympanic membrane reconstruction. Methods Our systematic search was conducted on November 24, 2021, using the CENTRAL, Embase, and MEDLINE databases. Observational studies with a minimum of 12 months of follow-up on type I tympanoplasty or myringoplasty were included, while non-English articles, patients with cholesteatoma or specific inflammatory diseases, and ossiculoplasty cases were excluded. The protocol was registered on PROSPERO (registration number: CRD42021289240) and PRISMA reporting guideline was used. Risk of bias was evaluated with the QUIPS tool. A random effect model was used in the analyses. Primary outcome was the rate of closed tympanic cavities. Results After duplicate removal, 9454 articles were found, of which 39 cohort studies were included. Results of four analyses showed significant effects: age (OR: 0.62, CI 0.50; 0.78, p value: 0.0002), size of the perforation (OR: 0.52, CI 0.29; 0.94, p value: 0.033), opposite ear condition (OR: 0.32, CI 0.12; 0.85, p value: 0.028), and the surgeon’s experience (OR: 0.42, CI 0.26; 0.67, p value: 0.005), while prior adenoid surgery, smoking, the site of the perforation, and discharge of the ear did not. Four factors: etiology, Eustachian tube function, concomitant allergic rhinitis, and duration of the ear discharge were analyzed qualitatively. Conclusions The age of the patient, the size of the perforation, the opposite ear status, and the surgeon’s experience have a significant effect on the success of tympanic membrane reconstruction. Further comprehensive studies are needed to analyze the interactions between the factors. Level of evidence Not applicable.

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