Comparison of endoscopic type I tympanoplasty/myringoplasty with or without tympanomeatal flap elevation for tympanic membrane repair: a systematic review and meta-analysis.

OBJECTIVES

This study aimed to compare the efficacy of endoscopic type I tympanoplasty/myringoplasty with (ETMFE) or without tympanomeatal flap elevation (ETMFNE).

METHODS

A thorough search of the PubMed, Embase and Cochrane Library databases was executed. The Review Manager 5.4 software was used for synthesising data, with forest plots illustrating the results for each outcome. Assessment of potential publication bias was conducted using funnel plots and Egger's test.

RESULTS

The meta-analysis included data from seven studies with 839 patients. The results demonstrated no significant difference in graft success rates (risk ratio = 1.01; 95 per cent confidence interval: 0.98-1.04; p = 0.54) or air-bone gap improvement (mean difference = -0.08; 95 per cent confidence interval: -2.02-1.85; p = 0.93) between the ETMFE and ETMFNE groups. However, the ETMFE group showed a pronounced increase in operation time (mean difference = 19.50; 95 per cent confidence interval: 10.75-28.25; p < 0.0001).

CONCLUSION

ETMFNE could be a preferable option for tympanic membrane perforation, offering similar efficacy to ETMFE but with reduced surgical time, particularly in appropriately selected cases.