Canal wall up versus canal wall down mastoidectomy techniques in the pediatric population with cholesteatoma: A systematic review and meta-analysis of comparative studies

医学 胆脂瘤 乳突切除术 荟萃分析 耳道 外科 放射科 病理
作者
Paola Solís-Pazmiño,Timo Siepmann,Patrick Scheffler,Noor‐E‐Seher Ali,Eddy Lincango-Naranjo,Tulio A. Valdez,Larry J. Prokop,Ben Min-Woo Illigens,Oscar J. Ponce,Iram Ahmad
出处
期刊:International Journal of Pediatric Otorhinolaryngology [Elsevier BV]
卷期号:173: 111658-111658 被引量:17
标识
DOI:10.1016/j.ijporl.2023.111658
摘要

The optimal surgical management of cholesteatoma remains controversial. Within pediatric otolaryngology, one of the most vital points of contention is the selection of canal wall-up (CWU) versus canal wall-down (CWD) procedures. Pediatric cholesteatoma has high rates of recurrence (16%–54%). In adults, there is evidence that the selection of surgical techniques affects recurrence rates. This has not been shown in children. 1. To systematically review the literature on recurrent and residual cholesteatoma after CWU and CWD in children and perform a meta-analysis of the data. 2. To assess the rates of recurrent and residual cholesteatoma between CWU and CWD techniques in pediatric patients. 3. To assess hearing outcomes by evaluating postoperative differences in the air-bone gap (ABG) between CWU and CWD techniques. A systematic search of PubMed, Embase, Scopus, and Cochrane Collaboration was performed from inception to May 1st, 2020, to identify studies that compared CWU and CWD procedures for acquired cholesteatoma in children. Search records were screened in duplicate by four reviewers. Inclusion criteria consisted of comparative randomized clinical trials and observational studies assessing outcomes of CWU and CWD techniques in the pediatric population. Studies involving patients with congenital cholesteatoma were excluded. Four reviewers working independently and in duplicate systematically reviewed and extracted study data. Dichotomous variables were analyzed as risk ratios (RR), while continuous variables were compared using weighted mean differences (MD). The risk of bias was assessed using the CLARITY Scale. The outcomes were recurrence, residual disease, air-bone gap (ABG), and air conductive (AC) thresholds. After screening 1036 publications, 17 retrospective cohort studies were selected. 1333 children were included; the overall mean age was ten years (SD 7.9), and the overall mean follow-up time was 5.9 years (SD 6.6). CWU and CWD techniques were performed in 60% (796) and 40% (537) cases. We did not find differences in cholesteatoma recurrence (RR: 1.50, 95% CI 0.94; 2.40; n = 544; I2 0%; Tau [2]: 0.00), or rates of residual cholesteatoma (RR 1.51, 95% CI 0.96; 2.38, n = 506; I2: 0%; Tau [2]: 0.00) in patients who underwent CWU and CWD mastoidectomy. The mean air-bone gap was lower with CWU than CWD (mean difference: 7.60, 95% CI -10.65; −4.54; n = 242; I2: 71%; Tau [2]: 5.98). and relevance: We show similar rates of recurrence and residual disease after either CWU or CWD tympanoplasty. Our results challenge the fundamental principle of CWD surgery as a standard technique, as there is no difference in rates of recurrence and residual disease in CWU and CWD. Moreover, audiometric results support CWU with improved hearing outcomes. PROSPERO identifier: CRD42020184029.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
小徐爱絮叨完成签到,获得积分20
刚刚
64658应助是小曹啊采纳,获得10
刚刚
文艺千柳应助Mine采纳,获得10
刚刚
栗子完成签到 ,获得积分10
刚刚
韩霖发布了新的文献求助10
1秒前
Y1311应助sun采纳,获得50
2秒前
深情安青应助苗条的龙哥采纳,获得10
2秒前
2秒前
2秒前
shm123321完成签到,获得积分10
2秒前
Lucas应助Lq采纳,获得10
3秒前
蔡蔡不菜菜完成签到,获得积分10
3秒前
hu发布了新的文献求助50
4秒前
jiying131发布了新的文献求助10
4秒前
浮游应助jrzsy采纳,获得10
4秒前
5秒前
tufuczy完成签到,获得积分10
5秒前
宏韬完成签到 ,获得积分10
5秒前
calm完成签到,获得积分10
5秒前
Joy完成签到,获得积分10
6秒前
孟博涵完成签到,获得积分10
6秒前
Sera发布了新的文献求助10
6秒前
小二郎应助kekeli采纳,获得10
6秒前
7秒前
7秒前
务实青亦完成签到,获得积分20
7秒前
Ava应助烂漫的从彤采纳,获得10
7秒前
8秒前
8秒前
礼岁岁发布了新的文献求助10
8秒前
小高完成签到,获得积分10
9秒前
山月发布了新的文献求助10
10秒前
务实青亦发布了新的文献求助10
11秒前
大橘为重完成签到 ,获得积分10
11秒前
12秒前
baobingzhiwu发布了新的文献求助10
12秒前
aa发布了新的文献求助10
12秒前
Hx完成签到 ,获得积分10
12秒前
莫溪月发布了新的文献求助10
13秒前
彭于晏应助Sera采纳,获得20
13秒前
高分求助中
(应助此贴封号)【重要!!请各用户(尤其是新用户)详细阅读】【科研通的精品贴汇总】 10000
Разработка технологических основ обеспечения качества сборки высокоточных узлов газотурбинных двигателей,2000 1000
Optimization and Learning via Stochastic Gradient Search 500
Nuclear Fuel Behaviour under RIA Conditions 500
Why America Can't Retrench (And How it Might) 400
Higher taxa of Basidiomycetes 300
Ricci Solitons in Dimensions 4 and Higher 240
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 物理化学 基因 催化作用 遗传学 冶金 电极 光电子学
热门帖子
关注 科研通微信公众号,转发送积分 4688750
求助须知:如何正确求助?哪些是违规求助? 4061435
关于积分的说明 12557156
捐赠科研通 3758855
什么是DOI,文献DOI怎么找? 2075942
邀请新用户注册赠送积分活动 1104622
科研通“疑难数据库(出版商)”最低求助积分说明 983700