Success rates in restoring hearing loss in patients with chronic otitis media: A systematic review

Laryngoscope Investigative Otolaryngology

article

Aaran Lewis PhD¹  Barbara Vanaelst PhD¹  Håkan Hua AuD, PhD¹  Byung Yoon Choi MD, PhD²  Rafael Jaramillo MD³  Kelvin Kong MBBS⁴  Jaydip Ray MD, PhD⁵  Alok Thakar MS, FRCSed⁶  Krister Järbrink PhD¹  Myrthe K. S. Hol MD, PhD⁷ 

[1] Cochlear Bone Anchored Solutions AB;Bundang Hospital, Seoul National University;Caldas Hospital SES;Hunter ENT;ENT Department, Sheffield Teaching Hospitals;All India Institute of Medical Sciences;Department of Otorhinolaryngology, Donders Center for Neurosciences, Radboud University Medical Center;Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen;Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen

关键词: cholesteatoma;    chronic otitis media;    hearing loss;    tympanoplasty;   

DOI  :  10.1002/lio2.576

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objective To assess the effectiveness of tympanoplasty in treating chronic otitis media-related hearing loss, published literature was systematically reviewed to determine the clinical success rate of tympanoplasty at restoring hearing in chronic otitis media patients at a minimum follow-up period of 12-months. Data Sources PubMed, Embase and the Cochrane Library. Methods Two independent reviewers performed literature searches. Publications reporting long-term (≥12-month) hearing outcomes and complications data on adult and pediatric patients with chronic otitis media were included and assessed for risk of bias and strength of evidence. To assess how tympanoplasty influences long-term hearing outcomes, data on pure tone audiometry (air-bone gap) and complications were extracted and synthesized. Results Thirty-nine studies met the inclusion criteria. Data from 3162 patients indicated that 14.0% of patients encountered postoperative complications. In adult patients, mean weighted air-bone gap data show closure from 26.5 dB hearing level (HL) (preoperatively) to 16.1 dB HL (postoperatively). In studies that presented combined adult and pediatric data, the mean preoperative air-bone gap of 26.7 dB HL was closed to 15.4 dB HL. In 1370 patients with synthesizable data, 70.7% of patients had a postoperative air-bone gap ˂ 20 dB HL at long-term follow-up. Finally, subgroup analysis identified that mean improvement in ABG closure for patients with and without cholesteatoma was 10.0 dB HL and 12.4 dB HL, respectively. Conclusion In patients with chronic otitis media, tympanoplasty successfully closed the air-bone gap to within 20 dB HL in 7/10 cases and had an overall complication rate of 14.0%. Level of Evidence 2a.

【 授权许可】

CC BY|CC BY-NC-ND