Our study aims to evaluate the effectiveness of mastoid obliteration compared to the
canal wall up (CWU) technique in cholesteatoma surgery based on the systematic review
of the literature and the meta-analysis of the data.The systematic search was performed
in four major databases (MEDLINE, Web of Science, Embase, and CENTRAL) on October
14, 2021. Studies comparing the CWU technique and mastoid obliteration were included.
The exclusion criteria were less than 12 months follow-up, congenital cholesteatoma,
indefinite description of the surgical method, and animal studies. The protocol was
registered on Prospero (registration number: CRD42021282485). The risk of bias was
evaluated with the ROBINS-I tool. Residual and recurrent disease proportions as primary
outcomes, quality of life, ear discharge, infection rates, hearing results, and operation
time as secondary outcomes were analyzed. In the quantitative synthesis, the random
effect model was used, and heterogeneity was identified.A total of 11 articles with
2077 operations' data were found eligible. All the identified studies were retrospective
cohorts. The odds of pooled residual and recurrent disease proportion were significantly
lower in the obliteration group compared to CWU (OR = 0.45, CI:0.28;0.80, p = 0.014).
However, when separated, the proportion of ears with recurrent (OR = 0.41, CI:0.11;1.57,
p = 0.140) or residual (OR = 0.59, CI:0.23, 1.50, p = 0.207) disease did not show
a significant difference, even though the odds were quite similar. The qualitative
synthesis identified no significant difference in the secondary outcomes, but obliteration
elongated the operation time.Mastoid obliteration significantly decreased the proportion
of residual and recurrent cholesteatoma in pooled analyses compared to the CWU technique
with low-quality of data.NA Laryngoscope, 2022.
