Efficacy of Eustachian Tube Function Tests in Predicting Myringoplasty Success Rate

Abstract Background Tympanoplasty is a commonly performed surgical procedure to close perforations of the tympanic membrane. The results of tympanic membrane based on multiple factors as the eustachian tube dysfunction. Aim of the Work to assess the efficacy of the eustachian tube function test in predicting myringoplasty success rate and compare the efficacy of different tests in prediction of myringoplasty outcome. Material and Methods An electronic search via PubMed, Cochrane library, google scholar and web of science (WOS) until janurary2021.We included articles published in English language and conducts adult cases only. We excluded studies based on expert opinion and laboratory studies. Outcomes of interest were success rate of tympanoplasty according to eustachian tube function test and the efficacy of the different tests of eustachian tube function. Analysis was conducted using Comprehensive Meta Analysis© version 3 (Biostat© Englewood, NJ) and the jamovi project (2021); jamovi (Version 1.6.23.0) [Computer Software] for the efficacy of the eustachian tube function tests in predicting tympanoplasty success rate and using Review Manager (RevMan) [Computer program]. Version 5.4. The Cochrane Collaboration, 2020, and MetaDTA: Diagnostic Test Accuracy Meta-Analysis v2.01, 2021 for detecting and comparing the accuracy of different eustachian tube function tests. Results Regarding tympanoplasty success rate meta-analysis of the revelent 14 studies shows that preoperative normal Eustachian tube function is associated with significantly higher probability of successful graft taking (Log odds ratio = 1.78, 95% CI = 1.10 to 2.46).Regarding to the different accuracy of eustachian tube function test meta-analysis of the revelent 14 studies shows that accuracy of the tests are ranked as follows: methylene blue (most accurate), saccharine, impedance audiometry, tubomanometry and sonotubometry (least accurate). Further studies are needed to validate our findings. Conclusions Our pooled estimate suggest a good benefits of preoperative eustachian tube function test and tympanoplasty success rate. According to efficacy of different test of tympanoplasty our pooled estimate that methylene blue test is the most accurate test while the sonotubometry test is the least accurate test.However, our evidence have several limitations and there is controversy among these studies. We suggest further studies are needed to validate our findings to detect the most accurate test of eustachian tube function.