الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Background: Tympanoplasty and myringoplasty are commonly used operations for treating patients suffering from chronic otitis media. Using the microscope in tympanoplasty has been the conventional procedure for repairing perforated tympanic membranes since the 1950s, but ear surgeons have increasingly practised endoscope-assisted tympanoplasty since the late 1990s.
Objective: to analyze and compare the available data about
the outcomes of endoscopic and microscopic type I tympanoplasty.
Data Sources: PubMed, Cochrane library Ovid, Scopus, Google scholar, and ClinicalTrials.
Methods: We conducted a meta-analysis in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We included comparative studies describing type I tympanoplasty, and comparing surgical outcomes of
the endoscope with the microscope in terms of efficacy and safety. Efficacy was measured by standardized mean difference (SMD) with 95% confidence interval (CI) for operative time and postoperative
air-bone gap (ABG) improvement; and odds ratio (OR) with 95% CI for graft uptake rate. Safety was measured by OR with 95% CI for additional maneuvers rate (i.e. canaloplasty and posterior wall curettage), postoperative pain rate and complications rate.
Results: Our systematic search yielded 22 studies (involving 1578 interventions; with 766 in the endoscopic group, and 812 in
the microscopic group) meeting the inclusion criteria and eligible for analysis. The pooled graft uptake rates and hearing results of endoscopic and microscopic tympanoplasty showed non-significant differences (OR: 0.95; 95% CI 0.68 to 1.34; p = 0.79; I2 = 0%)
(SMD of ABGs improvement: 0.03; 95% CI -0.33 to 0.39; p = 0.87;
I2 = 89%). In contrast, the endoscopic type I tympanoplasty outperforms the microscopic tympanoplasty regarding a highly significant decrease not only in pooled mean operative time but in
the pooled rates of the additional maneuvers, postoperative pain and complications.
Conclusions: Based on our meta-analysis, the surgical outcomes of endoscope-assisted and microscope-assisted type I tympanoplasty in terms of postoperative hearing results and the graft uptake rate were comparable. Operative time, additional maneuvers rate, postoperative pain rate and complications rate, on the other hand, proved to be significantly reduced with using the endoscope compared to using
the microscope. Hence, the endoscope is as efficient as the microscope in type I tympanoplasty but less invasive, fewer in complications and shorter in operative time.