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The effectiveness and safety of growth factors in the treatment of tympanic membrane perforations: a systematic review and meta-analysis of randomized controlled trials

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To determine the clinical efficacy and safety of growth factors in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs).

Methods

Databases, including PubMed, EMBASE, Cochrane library, Ebsco, Ovid, Scopus, and Web of Science, were searched for articles in any language about studies on the treatment of TM perforations with growth factors. Inclusion criteria were: (1) randomized controlled trials (RCTs); (2) only patients with TM perforations included; and (3) any kinds of growth factors or related products were used as an intervention. Exclusion criteria were: (1) study was not reported as a full paper, only as an abstract; (2) review studies and case reports; and (3) an inability to extract valid data. Outcomes of interest included perforation closure rate, closure time, hearing improvement, and complications.

Results

Nineteen RCTs with a total of 1335 participants were included. Growth factors effectively increased the rate of perforation closure [risk ratio (RR): 1.21 95% confidence interval (1.12, 1.30), p < 0.01] and shortened closure time [mean difference (MD): − 16.71 (− 22.74, − 10.15), p < 0.01]. There was no significant difference in hearing improvement [MD: 0.10 (− 0.50, 0.70), p = 0.74] or complications [RR: 1.49 (0.96, 2.32), p = 0.07] between the growth factor intervention group and the control group.

Conclusion

Growth factors are effective and safe in the treatment of TM perforations. However, better designed clinical trials should be carried out in the future to obtain more robust findings about the effectiveness of growth factors in the treatment of TM perforations.

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Authors and Affiliations

  1. Department of Otolaryngology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People’s Republic of China

    Shan Xu, Jintao Yu, Yue Hu, Bo Yang & Ning Yang

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Supplementary Information

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Online Resource 1. PRISMA checklist (PDF 402 KB)

Online Resource 2. Risk of bias graph (PDF 73 KB)

Online Resource 3. Risk of bias summary (PDF 150 KB)

405_2021_6891_MOESM4_ESM.pdf

Online Resource 4. Galbraith plots of outcomes with heterogeneity. Pooled outcome of perforation closure rate (A), perforation closure rate of FGF subgroup analysis (B), perforation closure rate of PDGF subgroup analysis (C), pooled outcome of closure time (D), closure time of FGF subgroup analysis (E), and closure time of EGF subgroup analysis (F)file4 (PDF 553 KB)

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Xu, S., Yu, J., Hu, Y. et al. The effectiveness and safety of growth factors in the treatment of tympanic membrane perforations: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol 279, 1863–1874 (2022). https://doi.org/10.1007/s00405-021-06891-6

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