ABSTRACT
Objectives: to analyze and compare the available data about the
outcomes of endoscopic and microscopic type I tympanoplasty.
Data Sources: PubMed, Cochrane library Ovid, Scopus, Google
scholar, and ClinicalTrials.
Methods: We conducted a meta-analysis in accordance with the
Preferred Reporting Items for Systematic
reviews and Meta-Analyses (PRISMA) guidelines. We included comparative
studies describing type I tympanoplasty, and comparing surgical outcomes
of the endoscope with the microscope in terms of efficacy and safety.
Results: Our systematic search yielded 22 studies meeting the
inclusion criteria and eligible for analysis. The pooled graft uptake
rates and audiological results of endoscopic and microscopic
tympanoplasty demonstrated non-significant differences. In contrast, the
endoscopic type I tympanoplasty outperforms the microscopic
tympanoplasty regarding a highly significant decrease not only in pooled
mean operative time but also in the pooled rates of the additional
maneuvers and complications.
Conclusions: Based on our meta-analysis, the surgical outcomes
of endoscope-assisted and microscope-assisted type I tympanoplasty in
terms of postoperative hearing outcomes and the graft uptake rate were
comparable. On the contrary, operative time, additional maneuvers rate,
and complications rate proved to be significantly reduced with endoscopy
compared to microscopy. Hence, the endoscope is as efficient as the
microscope in type I tympanoplasty but less invasive, fewer in
complications and shorter in operative time.
Keywords: Meta-analysis, Tympanoplasty, Myringoplasty,
Endoscope, Microscope, Tympanic membrane perforation.