(Open access funding provided by Semmelweis University)
Based on a systematic review and meta-analysis, our study aimed to provide information
about the factors that influence the success of tympanic membrane reconstruction.Our
systematic search was conducted on November 24, 2021, using the CENTRAL, Embase, and
MEDLINE databases. Observational studies with a minimum of 12 months of follow-up
on type I tympanoplasty or myringoplasty were included, while non-English articles,
patients with cholesteatoma or specific inflammatory diseases, and ossiculoplasty
cases were excluded. The protocol was registered on PROSPERO (registration number:
CRD42021289240) and PRISMA reporting guideline was used. Risk of bias was evaluated
with the QUIPS tool. A random effect model was used in the analyses. Primary outcome
was the rate of closed tympanic cavities.After duplicate removal, 9454 articles were
found, of which 39 cohort studies were included. Results of four analyses showed significant
effects: age (OR: 0.62, CI 0.50; 0.78, p value: 0.0002), size of the perforation (OR:
0.52, CI 0.29; 0.94, p value: 0.033), opposite ear condition (OR: 0.32, CI 0.12; 0.85,
p value: 0.028), and the surgeon's experience (OR: 0.42, CI 0.26; 0.67, p value: 0.005),
while prior adenoid surgery, smoking, the site of the perforation, and discharge of
the ear did not. Four factors: etiology, Eustachian tube function, concomitant allergic
rhinitis, and duration of the ear discharge were analyzed qualitatively.The age of
the patient, the size of the perforation, the opposite ear status, and the surgeon's
experience have a significant effect on the success of tympanic membrane reconstruction.
Further comprehensive studies are needed to analyze the interactions between the factors.Not
applicable.
