Comparison of endoscopic and microscopic ear surgery in pediatric patients

A meta-analysis

Sang Yoon Han, Doh Young Lee, Juyong Chung, Young Ho Kim

Research output: Contribution to journalReview articleResearchpeer-review

1 Citation (Scopus)

Abstract

Objectives: Recently, the endoscope has been increasingly introduced for middle-ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta-analysis of available literature. Methods: Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta-analysis was performed using a random-effects model and qualitative review was performed on the smaller studies. Results: Ten studies were identified as appropriate for quantitative meta-analysis and 19 studies for qualitative analysis. In the meta-analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.38-0.84, P =.005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95% CI: 0.41-1.26, P =.249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups. Conclusions: It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES. Laryngoscope, 129:1444–1452, 2019.

Original languageEnglish
Pages (from-to)1444-1452
Number of pages9
JournalLaryngoscope
Volume129
Issue number6
DOIs
StatePublished - 1 Jun 2019

Fingerprint

Ear
Meta-Analysis
Pediatrics
Cholesteatoma
Tympanoplasty
Odds Ratio
Databases
Confidence Intervals
Transplants
Laryngoscopes
Endoscopes
Middle Ear
PubMed
MEDLINE
Research Personnel
Recurrence

Keywords

  • Endoscopic ear surgery
  • cholesteatoma
  • chronic otitis media
  • pediatric
  • tympanoplasty

Cite this

Han, Sang Yoon ; Lee, Doh Young ; Chung, Juyong ; Kim, Young Ho. / Comparison of endoscopic and microscopic ear surgery in pediatric patients : A meta-analysis. In: Laryngoscope. 2019 ; Vol. 129, No. 6. pp. 1444-1452.
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abstract = "Objectives: Recently, the endoscope has been increasingly introduced for middle-ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta-analysis of available literature. Methods: Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta-analysis was performed using a random-effects model and qualitative review was performed on the smaller studies. Results: Ten studies were identified as appropriate for quantitative meta-analysis and 19 studies for qualitative analysis. In the meta-analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95{\%} confidence interval [CI]: 0.38-0.84, P =.005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95{\%} CI: 0.41-1.26, P =.249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups. Conclusions: It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES. Laryngoscope, 129:1444–1452, 2019.",
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Comparison of endoscopic and microscopic ear surgery in pediatric patients : A meta-analysis. / Han, Sang Yoon; Lee, Doh Young; Chung, Juyong; Kim, Young Ho.

In: Laryngoscope, Vol. 129, No. 6, 01.06.2019, p. 1444-1452.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Comparison of endoscopic and microscopic ear surgery in pediatric patients

T2 - A meta-analysis

AU - Han, Sang Yoon

AU - Lee, Doh Young

AU - Chung, Juyong

AU - Kim, Young Ho

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Y1 - 2019/6/1

N2 - Objectives: Recently, the endoscope has been increasingly introduced for middle-ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta-analysis of available literature. Methods: Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta-analysis was performed using a random-effects model and qualitative review was performed on the smaller studies. Results: Ten studies were identified as appropriate for quantitative meta-analysis and 19 studies for qualitative analysis. In the meta-analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.38-0.84, P =.005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95% CI: 0.41-1.26, P =.249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups. Conclusions: It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES. Laryngoscope, 129:1444–1452, 2019.

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JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

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