Alfonso Scarpa1, Pasquale Marra2, Massimo Ralli3, Pasquale Viola4, Federico Maria Gioacchini5, Giuseppe Chiarella4, Francesco Antonio Salzano2, Pietro De Luca2, Filippo Ricciardiello6, Claudia Cassandro7, Grazia Maria Corbi8. 1. Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131, Salerno, Italy. ascarpa@unisa.it. 2. Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131, Salerno, Italy. 3. Department of Sense Organs, Sapienza University of Rome, Rome, Italy. 4. Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy. 5. ENT Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. 6. Ear, Nose, and Throat Unit, AORN "Antonio Cardarelli", 80131, Naples, Italy. 7. Department of Surgical Sciences, University of Turin, Turin, Italy. 8. Department Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Abstract
OBJECTIVE: To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy. METHODS: A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air-bone gap (ABG) closure after surgical intervention. RESULTS: Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge's g = 0.04, 95% CI - 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge's g = 0.00, 95% CI - 0.20 0.21). CONCLUSIONS: Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
OBJECTIVE: To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy. METHODS: A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air-bone gap (ABG) closure after surgical intervention. RESULTS: Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge's g = 0.04, 95% CI - 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge's g = 0.00, 95% CI - 0.20 0.21). CONCLUSIONS: Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
Authors: Gordon H Guyatt; Andrew D Oxman; Regina Kunz; David Atkins; Jan Brozek; Gunn Vist; Philip Alderson; Paul Glasziou; Yngve Falck-Ytter; Holger J Schünemann Journal: J Clin Epidemiol Date: 2010-12-30 Impact factor: 6.437
Authors: Arnold J N Bittermann; Robert Vincent; Maroeska M Rovers; Geert J M G van der Heijden; Rinze A Tange; Wouter A Dreschler; Wilko Grolman Journal: Otol Neurotol Date: 2013-07 Impact factor: 2.311
Authors: Matthew J Page; Joanne E McKenzie; Patrick M Bossuyt; Isabelle Boutron; Tammy C Hoffmann; Cynthia D Mulrow; Larissa Shamseer; Jennifer M Tetzlaff; Elie A Akl; Sue E Brennan; Roger Chou; Julie Glanville; Jeremy M Grimshaw; Asbjørn Hróbjartsson; Manoj M Lalu; Tianjing Li; Elizabeth W Loder; Evan Mayo-Wilson; Steve McDonald; Luke A McGuinness; Lesley A Stewart; James Thomas; Andrea C Tricco; Vivian A Welch; Penny Whiting; David Moher Journal: BMJ Date: 2021-03-29