Additional maneuvers
Additional maneuvers refer to performing canaloplasty, posterior wall curettage or both on the EAC. They are necessary in some cases for better visualization and ossicular assessment. Ten studies analyzed the canaloplasty rate, with a total of 681 interventions, while only three studies analyzed the posterior wall curettage rate, with a total of 164 interventions.
Regarding the canaloplasty rate, the pooled analysis (Figure 5A) demonstrated that ET showed a highly significant decrease in the canaloplasty rate compared to MT (0.3% vs. 17.6%; OR: 0.08; 95% CI 0.03 to 0.21; p < 0.00001). In addition, neither heterogeneity (I2 = 0%, p = 0.98) nor publication bias was found (Figure 5B).
Regarding the posterior wall curettage rate, the pooled analysis (Figure 5A) demonstrated that ET showed a highly significant decrease in posterior wall curettage rate compared to MT (0% vs. 14.6%; OR: 0.10; 95% CI 0.02 to 0.56; p = 0.009). In addition, no heterogeneity (I2 = 0%, p = 0.86) was found.
The overall effect of pooling both subgroups showed that the rate of required additional maneuvers was significantly lower in ET than in MT (0.2% vs. 17.1%; OR: 0.09; 95% CI 0.04 to 0.19; p < 0.00001).