儿童鼓膜修补术与1型鼓室成形术的结局：系统综述与荟萃分析
Outcome of myringoplasty and type 1 tympanoplasty in children: a systematic review and meta-analysis.
文献信息
| PMID | 42900198 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ho Hwee Yee |
| 作者单位 | Department of Otorhinolaryngology - Head & Neck Surgery, School of Medical Sciences, USM Health Campus Kubang Kerian, Campus Kubang Kerian, 16150, Bharu, Kelantan, Malaysia. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 通过系统综述与荟萃分析评估儿童人群鼓膜修补术与1型鼓室成形术的解剖学与听力学结局。
方法： 对PubMed、Scopus、Web of Science和Cochrane Library数据库进行系统检索，纳入2021年1月至2025年9月发表的研究。纳入年龄≤18岁、接受鼓膜修补术或1型鼓室成形术的患者。采用随机效应荟萃分析估计鼓膜闭合与术后并发症的合并比例，以及合并平均气骨导差（ABG）改善。进行了异质性、发表偏倚、敏感性分析、亚组分析和荟萃回归分析。使用JBI关键评价清单评估研究的偏倚风险，并根据方法学限制将其分为低、中或高偏倚风险。
结果： 共纳入38项研究，包含4658耳。合并鼓膜闭合率为85.8%（95% CI：83.3至88.3），存在显著异质性（I² = 81.0%）。术后感染、角化珠形成和再穿孔的合并率分别为11.6%、4.0%和11.5%。合并平均术后气骨导差（ABG）增益为11.18 dB（95% CI：9.55至12.81）。亚组分析显示，偏倚风险较高的研究成功率显著更高。
结论： 儿童鼓膜修补术与1型鼓室成形术显示出较高的解剖学成功率和有意义的听力改善，并发症发生率相对较低。然而，显著的异质性和研究设计的变异性要求对这些发现进行谨慎解读。
英文摘要
OBJECTIVE: To evaluate the anatomical and audiological outcomes of myringoplasty and type I tympanoplasty in the pediatric population through systemic review and meta-analysis.
METHOD: A systematic search of PubMed, Scopus, Web of Science and Cochrane Library databases was conducted for studies published between January 2021 until September 2025. Studies involving patients ≤ 18 years undergoing myringoplasty or type 1 tympanoplasty were included. Random-effects meta-analysis was performed to estimate pooled proportions of tympanic membrane closure and postoperative complications, as well as pooled mean air-bone gap (ABG) improvement. Heterogeneity, publication bias, sensitivity analyses, subgroup analyses, and meta-regression were performed. The risk of bias of studies was evaluated using JBI Critical Appraisal Checklist and categorizing them into low, moderated or high risk of bias according to methodological constraints.
RESULT: Thirty-eight studies comprising 4658 ears were included. The pooled tympanic membrane closure rate was 85.8% (95% CI: 83.3 to 88.3), with substantial heterogeneity (I² = 81.0%). The pooled rates of postoperative infection, keratin pearl formation, and recurrent perforation rates were 11.6%, 4.0%, and 11.5%, respectively. The pooled mean postoperative air-bone gap (ABG) gain was 11.18 dB (95% CI: 9.55 to 12.81). Subgroup analysis demonstrated significantly higher success rates in studies with higher risk of bias.
CONCLUSION: Myringoplasty and type 1 tympanoplasty in children demonstrate high anatomical success rates and meaningful hearing improvement with relatively low complication rates. However, substantial heterogeneity and variability in study design warrant cautious interpretation of these findings.