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Type I Tympanoplasty Meta-analysis: A Single Variable Analysis of More Than 26 Thousand Adults and Children From 214 Studies

Presenting Author: Hsern Ern Tan

Published online by Cambridge University Press:  03 June 2016

Hsern Ern Tan
Affiliation:
1. Sir Charles Gairdner Hospital, 2. Ear Science Institute of Australia
Peter Santa Maria
Affiliation:
1. Sir Charles Gairdner Hospital, 2. Ear Science Institute Australia
Robert Eikelboom
Affiliation:
1. Sir Charles Gairdner Hospital, 2. Ear Science Institute Australia
Marcus Atlas
Affiliation:
1. Sir Charles Gairdner Hospital, 2. Ear Science Institute Australia
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Abstract

Type
Abstracts
Copyright
Copyright © JLO (1984) Limited 2016 

Learning Objectives:

Objective: To determine which independent variables influencing the efficacy of type I tympanoplasty in adult and pediatric populations.

Data Sources: A search of the PubMed database and Cochrane Database of Systematic Reviews using the key words “tympanoplasty OR myringoplasty” from January 1966 to July 2014 was performed.

Study Selection: Studies reporting outcomes of myringoplasty or Type I tympanoplasty in primary non-cholesteatomatous chronic tympanic membrane perforation were included.

Data Extraction: Of 4,698 abstracts reviewed, 214 studies involving 26,097 cases met our inclusion criteria and contributed to meta-analysis.

Data Synthesis: The primary outcome of success was defined as closure rate at 12 months. The independent variables analyzed were age, follow-up period, approach, graft material, perforation cause, size, location, ear dryness, and surgical technique. Only those studies providing data on a given parameter of interest could be included when comparing each variable.

Conclusion: The weighted average success rate of tympanic closure was 86.6%. Based on this meta-analysis, there is a failure rate of tympanoplasty observed over time (worsened by 4.4% in follow-up periods >12 months). Pediatric surgery has a 5.8% higher failure rate than adults. Other variables associated with improved closure rates include perforation with a size less than 50% of total area (improved by 6.1%) and the use of cartilage as a graft (improved by 2.8% compared to fascia), while ears that were operated on while still discharging, those in different locations of the pars tensa, or using different surgical approaches or techniques did not have significantly different outcomes.