A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty.


Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
02 2021
Historique:
received: 22 01 2020
revised: 01 06 2020
accepted: 12 06 2020
pubmed: 12 11 2020
medline: 20 1 2021
entrez: 11 11 2020
Statut: ppublish

Résumé

Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small-intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air-bone gap of 5.6 dB was found in the 23% of studies reporting this metric. The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392-400, 2021.

Identifiants

pubmed: 33176008
doi: 10.1002/lary.28914
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

392-400

Informations de copyright

© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

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Auteurs

Iman Ghanad (I)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

Marc D Polanik (MD)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.
Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A.

Danielle R Trakimas (DR)

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

Renata M Knoll (RM)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

Melissa Castillo-Bustamante (M)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

Nicole L Black (NL)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

Elliott D Kozin (ED)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

Aaron K Remenschneider (AK)

Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.
Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A.

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