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Comparison between endoscopic and microscopic butterfly cartilage graft inlay tympanoplasty: a systematic review and meta-analysis

  • Otology
  • Published:
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Abstract

Purpose

The purpose of this study was 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. RoB-2 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, in which a total of 318 patients were included. Graft take rate was 91.3% in the endoscopic group and 93.6% in the microscopic 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 to 2.48).

Conclusion

Although the overall evidence of the included studies was low, endoscopic and microscopic butterfly cartilage graft inlay tympanoplasties have similar results on anatomical and hearing outcomes, making the selection between such approaches an individual choice for the surgeon.

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Acknowledgements

The authors are grateful to Dr. Lana Catani Ferreira Pinto, MD, PhD for the statistical support.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Medical School of Federal, University of Health Sciences of Porto Alegre (UFCSPA), Rua Ciro Gavião 601, apt 195, Porto Alegre, RS, 90470-020, Brazil

    José Faibes Lubianca Neto & Tales Antunes Fanzini

  2. Graduate Program in Pediatrics of UFCSPA, Porto Alegre, RS, Brazil

    José Faibes Lubianca Neto

  3. Otorhinolaryngology Service of Santa Casa de Misericórdia Hospital of Porto Alegre, Porto Alegre, RS, Brazil

    José Faibes Lubianca Neto, Artur Koerig Schuster & Lucas Rodrigues Mostardeiro

  4. Pediatric Otolaryngology Service of Santo Antonio Children’s Hospital of Porto Alegre, Porto Alegre, RS, Brazil

    José Faibes Lubianca Neto, Artur Koerig Schuster & Lucas Rodrigues Mostardeiro

  5. Medical School of Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    João Pedro Neves Lubianca

  6. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Roland Douglas Eavey

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  1. José Faibes Lubianca Neto
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Correspondence to José Faibes Lubianca Neto.

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Lubianca Neto, J.F., Schuster, A.K., Fanzini, T.A. et al. Comparison between endoscopic and microscopic butterfly cartilage graft inlay tympanoplasty: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 280, 151–158 (2023). https://doi.org/10.1007/s00405-022-07477-6

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