Type I Tympanoplasty Meta-Analysis: A Single Variable Analysis.
To determine which independent variables influence the efficacy of type I tympanoplasty in adult and pediatric populations.



A search of the PubMed database and Cochrane Database of Systematic Reviews using the key words "tympanoplasty OR myringoplasty" from January 1966 to July 2014 was performed.



Studies reporting outcomes of myringoplasty or Type I tympanoplasty in primary non-cholesteatomatous chronic tympanic membrane (TM) perforation were included.



Of 4,698 abstracts reviewed, 214 studies involving 26,097 patients met our inclusion criteria and contributed to meta-analysis.



The primary outcome of success was defined as closure rate at 12 months. The independent variables analyzed were age, follow-up period, approach, graft material, perforation cause, size, location, ear dryness, and surgical technique. Only those studies providing data on a given parameter of interest could be included when comparing each variable.



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.
*Ear Science Institute of Australia, Subiaco, Western Australia, Australia †Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia ‡Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia §Department of Otolaryngology, Head and Neck Surgery, Stanford University, Palo Alto, California ||Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Hsern Ern
HE
Tan
Peter Luke
PL
Santa Maria
Robert Henry
RH
Eikelboom
Keith Surendran
KS
Anandacoomaraswamy
Marcus David
MD
Atlas
D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*