Type I Tympanoplasty Meta-Analysis

Abstract

The weighted average success rate of tympanic closure was 86.6%. Based on this meta-analysis, pediatric surgery has a 5.8% higher failure rate than adults and there is no correlation between follow-up period and success. 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 with 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.

Delayed failure in tympanoplasty: A 20‐year study of the incidence and reasons for re‐perforation in 359 patients

“…In the meta-analysis by Tan et al, 4 higher tympanoplasty failure rates were seen in studies with follow-up periods >12 months (4.38% worse with follow-up periods > 12 months when compared to follow-up periods < 6 months). There was, however, no overall statistically significant correlation between follow-up period and the success rate.…”

The Effect of Nitrous Oxide on the Outcomes of Underlay Tympanoplasty: A Prospective Study

“…10 In a meta-analysis, Tan et al reported that similar outcomes were observed between the underlay and the overlay techniques, but graft lateralization was observed mostly after the overlay technique. 11 Nitrous oxide is a cheap and readily available anesthetic agent with less of a depressive effect on the cardiovascular system than certain other anesthetics. However, N 2 O can increase pressure in closed cavities, such as the middle ear.…”

Our experience of long‐term result of tympanoplasty using areolar tissue in 359 patients

“…In one meta-analysis, highest failure rates were detected in studies with follow-up periods greater than 12 months (4.38% worse with follow-up periods >12 months compared with <6 months). 8 While the most frequent causes of immediate graft perforation are infection or technical in nature, late re-perforations are typically multifactorial and often associated with underlying eustachian tube dysfunction, episodes of acute otitis media, chronic sinusitis, tympanic membrane atrophy and implantation cholesteatoma. 9 Becvarovski showed that delayed graft failure was also more commonly seen in smokers (60%) than non-smokers (20%).…”