The Prognostic Value of Active Otitis Media on Tympanoplasty Success Rate—A Systematic Review

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-07-30 DOI:10.1111/coa.14205

Hanae Fumiyo Namba, Mariëlle Bernadette Plug, Adriana Leni Smit

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Abstract

Objectives

The aim is to investigate the influence of an active otitis media on the success rate of tympanoplasty in patients with a chronic otitis media (COM) and a tympanic membrane perforation.

Databases Reviewed

PubMed, Embase and the Cochrane Library.

Methods

The inclusion criteria were studies on closure rates of tympanoplasty performed in COM patients of any age with a tympanic membrane perforation caused by COM. The exclusion criteria were studies on patients undergoing concomitant mastoidectomy, ossicular chain reconstruction, tuboplasty, adenoidectomy, revision tympanoplasty, patients with perforations due to other conditions than COM, and letters to editors, commentaries, conference abstracts and case reports. The included articles were critically appraised using the QUIPS tool. Data on tympanic membrane closure rate were extracted, odds ratio (OR) and 95% confidence intervals (CI) of the closure rate with a wet versus a dry ear were calculated.

Results

The search was performed on 1 February 2023. Of 4671 articles, 16 studies were included and critically appraised. Of these observational studies (nine prospective, seven retrospective), with a total of 1509 patients (dry ear group n = 1003; wet ear group n = 506), two studies stated a significant difference in success rate, one in favour of a dry ear and one in favour of a wet ear at time of surgery. All other studies did not show a statistically significant difference. Overall, the risk of bias was considered moderate to high.

Conclusions

We found no significant prognostic value of having an active otitis media during tympanoplasty on tympanic membrane closure rates. Because the overall risk of bias was considered moderate to high, no strong conclusions can be made. To be able to answer this question with higher levels of evidence, high-quality prospective or randomized studies are needed.

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活动性中耳炎对鼓室成形术成功率的预后价值--系统性综述。

目的：目的：研究活动性中耳炎对慢性中耳炎（COM）和鼓膜穿孔患者鼓室成形术成功率的影响：方法：纳入标准：对任何年龄段、由慢性中耳炎（COM）引起鼓膜穿孔的慢性中耳炎患者进行鼓室成形术的闭合率研究。排除标准是对同时接受乳突切除术、听骨链重建术、鼓室成形术、腺样体切除术、翻修鼓室成形术的患者，因其他疾病（COM除外）导致鼓膜穿孔的患者，以及致编辑的信、评论、会议摘要和病例报告进行的研究。采用 QUIPS 工具对纳入的文章进行了严格评估。提取鼓膜闭合率数据，计算湿耳与干耳闭合率的几率比（OR）和 95% 置信区间（CI）：检索于 2023 年 2 月 1 日进行。在 4671 篇文章中，有 16 项研究被纳入并进行了严格评估。在这些观察性研究（9 项前瞻性研究，7 项回顾性研究）中，共有 1509 名患者接受了手术（干耳组 n = 1003；湿耳组 n = 506），其中有两项研究表明手术成功率存在显著差异，一项是干耳组，另一项是湿耳组。其他所有研究均未显示出明显的统计学差异。总体而言，偏倚风险为中度至高度：我们发现，鼓室成形术期间活动性中耳炎对鼓膜闭合率没有明显的预后价值。由于总体偏倚风险为中度至高度，因此无法得出有力的结论。要想以更高的证据水平回答这一问题，需要进行高质量的前瞻性或随机研究。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.