Abstract:
Packing of tympanic cavity is generally considered an essential step in myringoplasty. However, each packing material comes with one or another side e ect. The objective of this meta-analysis was to compare the results of Type 1 myringoplasty with or without packing. Pubmed, Cochrane database, Embase, Google Scholar, and clinicaltrials.gov were searched using tympanoplasty or myringoplasty and packing as the search query. All RCTs / quasi-RCTs comparing tympanoplasty Type 1 with packing (controlv)ersus without packing (intervention) of tympanic cavity in the human population were included. For dichotomous and continuous outcomes, relative risks (RR) and mean di erences (MD) were calculated with 95% con dence interval, respectively. Heterogeneity was assessed usin g2 sItatistics. Publication bias was checked using funnel plot and Egger s test, if applicable. Quality of evidence was assessed for each outcome using GRADE approach. Eleven studies were deemed eligible. For graft uptake and functional success rate, RR of 1.01 and 1.05 were obtained, respectively, showing no signi cant di erences between the intervention and control groups. Astt 1and 3rd postoperative month, nopacking group showed 3.86 dB and 2.08 dB better air-bone gap (ABG) closure than the packing group, respectively. Also, intervention with no-packing was 9.28-minute shorter procedure. With RR 0.35, no-packing had signi cantly lesser postoperative aural fullness. Type 1 tympanoplasty performed with or without packing show comparable results in terms of graft uptake and functional success rate. However, if performed without packing, it takes shorter time, provides early hearing improvement and causes less aural fullness.
Keywords:
Metaanalysis
,
Nopacking
,
Gelfoam
,
Packing
,
Endoscopic myringoplasty
,
Tympanoplasty Type 1