title: Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: A systematic review and meta-analysis.
abstract: Microscopic tympanoplasty has been the standard surgery for repairing perforated tympanic membranes since the 1950s, but endoscopic tympanoplasty has been increasingly practiced since the late 1990s. In this study, we compared the efficacies of endoscopic and microscopic tympanoplasty.
  
  
  
  PubMed, Embase, MEDLINE, and the Clinical Trial Register.
  
  
  
  We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We included clinical studies that compared the efficacies of endoscopic and microscopic tympanoplasty. We assessed the risk of bias and calculated the pooled relative risk (RR) estimates with 95% confidence interval (CI).
  
  
  
  We identified four studies (involving 266 patients in total) that met the inclusion criteria. The pooled tympanic membrane closure rates and hearing results of endoscopic and microscopic tympanoplasty were comparable (85.1% vs. 86.4%, respectively; RR: 0.98; 95% CI: 0.85 to 1.11; I2= 0) (mean difference of improvements of air-bone gaps: -2.73; 95% CI: -6.73 to 1.28; I2= 80%). The pooled canalplasty rate of endoscopic tympanoplasty was significantly lower than that of microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty had a more desirable cosmetic result than did those receiving microscopic tympanoplasty.
  
  
  
  Our up-to-date review evidences the comparable tympanic membrane closure rates and hearing results for endoscopic and microscopic tympanoplasty. Patients receiving endoscopic tympanoplasty have a lower canalplasty rate and more desirable cosmetic result than do those receiving microscopic tympanoplasty. Laryngoscope, 127:1890-1896, 2017.
authors.affiliation: Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.|Department of Otolaryngology, PoJen General Hospital, Taipei, Taiwan.
authors.forename: Chih-Chieh
authors.initials: CC
authors.lastname: Tseng
authors.affiliation: Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ming-Tang
authors.initials: MT
authors.lastname: Lai
authors.affiliation: Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.|Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chia-Che
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Sheng-Po
authors.initials: SP
authors.lastname: Yuan
authors.affiliation: Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Ding
mesh_terms: D004724:Endoscopy; D006801:Humans; D008866:Microsurgery; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
keywords: Chronic otitis media; endoscope; microscope; tympanic perforation; tympanoplasty