Bo Li1, Lingyun Zhou2, Miaowei Wang3, Yanwen Wang4, Jian Zou5. 1. Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. 2. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China. 3. Center of Rehabilitation, West China Hospital, Sichuan University, Chengdu 610041, China. 4. West China Medical School, Sichuan University, Chengdu 610041, China. 5. Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: ronent@foxmail.com.
Abstract
OBJECTIVE: Endoscopic ear surgery (EES) is minimally invasive and increasingly used to treat middle ear disease. In this meta-analysis, we compared the efficacies of EES and microscopic ear surgery (MES) in patients with middle ear cholesteatoma. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for studies that reported the comparative surgical outcomes of EES and MES in patients with middle ear cholesteatoma. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. All included studies involved ≥1 of the following outcomes: recurrence of or residual disease, graft intake success rate, audiological performance, and operation time. We calculated the pooled relative risk (RR) or weighted mean difference with 95% confidence intervals (CIs) by using STATA software. RESULTS: Thirteen studies were included in the quantitative meta-analysis. The pooled recurrence and residual rates of cholesteatoma were significantly lower in the EES group than in the MES group [RR: 0.51, 95%CI: 0.31-0.84, heterogeneity (I2) = 4.7%; P = .394; RR: 0.68; 95%CI: 0.47-0.99; I2 = 0.0%; P = .878; respectively]. There were no significant differences in other parameters, such as graft intake success rates, audiological performance, and operation times, between the 2 groups. CONCLUSION: The pooled results showed that EES reduced the residual lesion rate and postoperative recurrence risk in patients with middle ear cholesteatoma. However, there was insufficient evidence to prove that EES was advantageous in graft intake success rate auditory performance, and operation time.
OBJECTIVE: Endoscopic ear surgery (EES) is minimally invasive and increasingly used to treat middle ear disease. In this meta-analysis, we compared the efficacies of EES and microscopic ear surgery (MES) in patients with middle ear cholesteatoma. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for studies that reported the comparative surgical outcomes of EES and MES in patients with middle ear cholesteatoma. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. All included studies involved ≥1 of the following outcomes: recurrence of or residual disease, graft intake success rate, audiological performance, and operation time. We calculated the pooled relative risk (RR) or weighted mean difference with 95% confidence intervals (CIs) by using STATA software. RESULTS: Thirteen studies were included in the quantitative meta-analysis. The pooled recurrence and residual rates of cholesteatoma were significantly lower in the EES group than in the MES group [RR: 0.51, 95%CI: 0.31-0.84, heterogeneity (I2) = 4.7%; P = .394; RR: 0.68; 95%CI: 0.47-0.99; I2 = 0.0%; P = .878; respectively]. There were no significant differences in other parameters, such as graft intake success rates, audiological performance, and operation times, between the 2 groups. CONCLUSION: The pooled results showed that EES reduced the residual lesion rate and postoperative recurrence risk in patients with middle ear cholesteatoma. However, there was insufficient evidence to prove that EES was advantageous in graft intake success rate auditory performance, and operation time.