{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:46:23Z","timestamp":1790635583195,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Endoscopic ear surgery is no longer a promising technique, but a well\u2010established one. This study aims to compare endoscopic and microscopic tympanoplasty based on current literature evidence, in terms of their efficacy and safety characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>We conducted a systematic literature search of four medical databases (Pubmed, Cochrane Library, Scopus, ClinicalTrials.gov), focusing on randomized controlled or observational studies comparing microscopic to endoscopic tympanoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Data related to the efficacy and safety of each technique were extracted. Outcome data were summarized using pooled mean differences or pooled odds ratio along with their 95% confidence intervals. The risk of bias was estimated, by using the ROBINS\u2010I and RoB\u2010II assessment tools, while the overall quality of evidence was evaluated according to the GRADE working group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three studies, with 2646 patients in total, were included in the meta\u2010analysis. Success rate was evaluated by estimating tympanic graft failure (pooled mean difference:\u22120.23; 95% CI: \u22120.61, 0.14, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200933.42%), and air\u2010bone gap improvement (pooled mean difference:\u22120.05; 95% CI:\u22120.23, 0.13, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200952.69%), resulting in comparable outcomes for the two techniques. A statistically significant difference favoring the endoscopic technique was detected regarding postoperative wound infection (OR: \u22121.72; 95% CI: \u22123.39, \u22120.04, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), dysgeusia (OR: \u22121.47; 95% CI: \u22122.47, \u22120.47, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), otitis externa development (OR: \u22121.96; 95% CI: \u22123.23, \u22120.69, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), auricular numbness (OR: \u22122.56; 95% CI: \u22123.93, \u22121.19, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), as well as surgical duration (OR: \u22121.86; 95% CI: \u22122.70, \u22121.02, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200943.95%), when compared to the postauricular microscopic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic tympanoplasty is an innovative alternative to the microscopic technique, resulting in commensurate outcomes regarding success rate. Furthermore, it offers superior results concerning postoperative complications, while it presents a significant reduction in the duration of surgery, mainly when it is compared to the postauricular microscopic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 134:3466\u20133476, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31365","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T08:14:05Z","timestamp":1709108045000},"page":"3466-3476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Endoscopic Versus Microscopic Tympanoplasty: A Systematic Review and Metanalysis"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-3518","authenticated-orcid":false,"given":"Eleni","family":"Gkrinia","sequence":"first","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Ntziovara","sequence":"additional","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-4528","authenticated-orcid":false,"given":"Alexandros G.","family":"Brotis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tzimkas\u2010Dakis","sequence":"additional","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Saratziotis","sequence":"additional","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Korais","sequence":"additional","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2312-7218","authenticated-orcid":false,"given":"Jiannis","family":"Hajiioannou","sequence":"additional","affiliation":[{"name":"ENT Department University Hospital of Larissa  Larisa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.04.013"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.08.025"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001099"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.7874\/jao.2018.00549"},{"issue":"5","key":"e_1_2_6_6_1","first-page":"510","article-title":"Endoscope\u2010assisted myringoplasty","volume":"50","author":"Yadav S.","year":"2009","journal-title":"Singapore Med J"},{"key":"e_1_2_6_7_1","first-page":"325","volume-title":"Surgery of the Ear","author":"Dennis S.","year":"2003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000298"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002465"},{"key":"e_1_2_6_10_1","first-page":"372","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"2021","author":"Page MJ","year":"2020","journal-title":"BMJ"},{"key":"e_1_2_6_11_1","first-page":"4","article-title":"ROBINS\u2010I: a tool for assessing risk of bias in non\u2010randomised studies of interventions","volume":"355","author":"Sterne JA","year":"2016","journal-title":"BMJ (Online)"},{"key":"e_1_2_6_12_1","first-page":"1","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JAC","year":"2019","journal-title":"BMJ"},{"key":"e_1_2_6_13_1","volume-title":"GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations","author":"Sch\u00fcnemann H","year":"2013"},{"key":"e_1_2_6_14_1","unstructured":"The Jamovi project.Jamovi. 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