Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis
Background: The aim is to analyze Literature concerning mastoid obliteration in adults with either autologous or heterologous grafts in the last 10 years. Data Source: Databases such as NIH PubMed, Bookshelf, NLM Catalog, Cochrane Library, and Embase were consulted. Methods: Thirty-seven studies...
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| Format: | Article |
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2024-09-01
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| Series: | Journal of International Advanced Otology |
| Online Access: | https://www.advancedotology.org/en/heterologous-materials-are-really-better-than-autologous-in-tympanoplasty-mastoid-obliteration-a-systematic-review-with-meta-analysis-131951 |
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| _version_ | 1832557144869699584 |
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| author | Francesca Viberti Giovanni Monciatti Aniello Donniacuo Fabio Ferretti Lorenzo Salerni Andrea De Vito Daniele Bernardeschi Marco Mandalà |
| author_facet | Francesca Viberti Giovanni Monciatti Aniello Donniacuo Fabio Ferretti Lorenzo Salerni Andrea De Vito Daniele Bernardeschi Marco Mandalà |
| author_sort | Francesca Viberti |
| collection | DOAJ |
| description | Background: The aim is to analyze Literature concerning mastoid obliteration in adults with either autologous or heterologous grafts in the last 10 years. Data Source: Databases such as NIH PubMed, Bookshelf, NLM Catalog, Cochrane Library, and Embase were consulted.
Methods: Thirty-seven studies were selected (22 concerning autologous materials, 15 about heterologous ones). Only studies with more than 12 months of follow-up were considered. A statistical analysis with random-effects models was performed to allow the true effect sizes to differ from study to study.
Results: The present literature review and meta-analysis does not allow to establish the supremacy of one technique over the other, but underlines the advantages of each reconstructive choice and the importance of mastoid obliteration in cholesteatoma surgery. The total number of obliterated ears was 2882. Overall otorrhea rate was 5% (5.2% for heterologous grafts; 4.9% for autologous materials; P < .05). Recurrent and residual cholesteatoma rate was 4.5% (3.4% in heterologous materials; 5.2% in autologous grafts; P < .05). Recurrent cholesteatoma rate was 1.8% (1.6% when using heterologous grafts, 1.9% with autologous; P < .05). Residual cholesteatoma rate was 1.5% (1.6% with heterologous materials, 1.5% with autologous; P < .05). TM (tympanic membrane) retraction pockets rate was 5.3% (3.6% with heterologous materials; P >.05; 7% with autologous materials; P < .05). TM perforations rate was 2.9% (4.3% with heterologous materials, 2.5% with autologous; P < .05). Infection rate was 2.3% (2.3% with heterologous materials, 2.2% with autologous; P < .05).
Conclusion: Heterologous materials are associated with significantly lower rates of recurrent and residual cholesteatoma and retraction pockets development, although they are associated with higher rates of otorrhea and TM perforation. |
| format | Article |
| id | doaj-art-0e40453f9363475a9d4bb6506fbe2a86 |
| institution | Kabale University |
| issn | 2148-3817 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | AVES |
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| series | Journal of International Advanced Otology |
| spelling | doaj-art-0e40453f9363475a9d4bb6506fbe2a862025-02-03T05:37:42ZengAVESJournal of International Advanced Otology2148-38172024-09-0120543944910.5152/iao.2024.241262Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-AnalysisFrancesca Viberti0Giovanni Monciatti1Aniello Donniacuo2Fabio Ferretti3Lorenzo Salerni4Andrea De Vito5Daniele Bernardeschi6Marco Mandalà7Department of Otolaryngology University of Siena, Siena, ItalyDepartment of Otolaryngology University of Siena, Siena, ItalyDepartment of Otolaryngology University of Siena, Siena, ItalyDepartment of Statistics, University of Siena, Siena, ItalyDepartment of Otolaryngology University of Siena, Siena, ItalyDepartment of Otolaringology, Morgagni - Pierantoni Hospital, Forlì, ItalyDepartment of Otology, Auditory Implants and Skull Base Surgery, Hôpitaux Universitaires Pitié Salpêtrière, Paris, FranceDepartment of Otolaryngology University of Siena, Siena, ItalyBackground: The aim is to analyze Literature concerning mastoid obliteration in adults with either autologous or heterologous grafts in the last 10 years. Data Source: Databases such as NIH PubMed, Bookshelf, NLM Catalog, Cochrane Library, and Embase were consulted. Methods: Thirty-seven studies were selected (22 concerning autologous materials, 15 about heterologous ones). Only studies with more than 12 months of follow-up were considered. A statistical analysis with random-effects models was performed to allow the true effect sizes to differ from study to study. Results: The present literature review and meta-analysis does not allow to establish the supremacy of one technique over the other, but underlines the advantages of each reconstructive choice and the importance of mastoid obliteration in cholesteatoma surgery. The total number of obliterated ears was 2882. Overall otorrhea rate was 5% (5.2% for heterologous grafts; 4.9% for autologous materials; P < .05). Recurrent and residual cholesteatoma rate was 4.5% (3.4% in heterologous materials; 5.2% in autologous grafts; P < .05). Recurrent cholesteatoma rate was 1.8% (1.6% when using heterologous grafts, 1.9% with autologous; P < .05). Residual cholesteatoma rate was 1.5% (1.6% with heterologous materials, 1.5% with autologous; P < .05). TM (tympanic membrane) retraction pockets rate was 5.3% (3.6% with heterologous materials; P >.05; 7% with autologous materials; P < .05). TM perforations rate was 2.9% (4.3% with heterologous materials, 2.5% with autologous; P < .05). Infection rate was 2.3% (2.3% with heterologous materials, 2.2% with autologous; P < .05). Conclusion: Heterologous materials are associated with significantly lower rates of recurrent and residual cholesteatoma and retraction pockets development, although they are associated with higher rates of otorrhea and TM perforation.https://www.advancedotology.org/en/heterologous-materials-are-really-better-than-autologous-in-tympanoplasty-mastoid-obliteration-a-systematic-review-with-meta-analysis-131951 |
| spellingShingle | Francesca Viberti Giovanni Monciatti Aniello Donniacuo Fabio Ferretti Lorenzo Salerni Andrea De Vito Daniele Bernardeschi Marco Mandalà Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis Journal of International Advanced Otology |
| title | Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis |
| title_full | Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis |
| title_fullStr | Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis |
| title_full_unstemmed | Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis |
| title_short | Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis |
| title_sort | heterologous materials are really better than autologous in tympanoplasty mastoid obliteration a systematic review with meta analysis |
| url | https://www.advancedotology.org/en/heterologous-materials-are-really-better-than-autologous-in-tympanoplasty-mastoid-obliteration-a-systematic-review-with-meta-analysis-131951 |
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