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09-05-2024 | Ear Surgery | Otology

Success and safety of endoscopic versus microscopic resection of temporal bone paraganglioma: a meta-analysis

Authors: Hen Chaushu, Fares Butrus, Yahav Oron, Ophir Handzel, Rani Abu-Eta, Nidal Muhanna, Omer J. Ungar

Published in: European Archives of Oto-Rhino-Laryngology

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Abstract

Purpose

Temporal bone paraganglioma (TBP) are the most common tumors of the middle ear. They pose a challenge in otologic surgery due to their extensive vascularity and intricate location within the middle ear. This meta-analysis aimed to compare the safety and efficacy of two surgical approaches, microscopic middle ear surgery (MMES) and endoscopic middle ear surgery (EMES), in the resection of TBP.

Methods

Eligible studies published after 1988 were identified through systematic searches of “PubMed”, “Scopus” and “Google Scholar”. Retrospective studies and randomized/non-randomized control trials reporting on surgical approaches for TBP with a minimum of five adult patients were included.

Results

A total of 595 records were initially identified. After removing 229 duplicates, 349 articles were excluded based upon article subject, title and abstract. Following the review of full texts, 13 articles were assessed for eligibility. The pooled analysis included a total of 529 ears, with a complication rate of 7.8% for EMES and 14.2% for MMES. Subgroup differences indicated no significant variation between the two methods (p = 0.2945).

Conclusion

Both EMES and MMES demonstrated favorable surgical outcomes with low complication rates for TBP resection. These findings suggest that EMES is a safe and effective method for TBP resection and one that is comparable to MMES. Since the risk of bleeding is significant in these tumors, a third-hand technique, endoscopic bipolar cautery or laser-assisted hemostasis should be considered. Conversion to MMES is another option when visibility is critically affected by bleeding.

Level of evidence

3.
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Metadata
Title
Success and safety of endoscopic versus microscopic resection of temporal bone paraganglioma: a meta-analysis
Authors
Hen Chaushu
Fares Butrus
Yahav Oron
Ophir Handzel
Rani Abu-Eta
Nidal Muhanna
Omer J. Ungar
Publication date
09-05-2024
Publisher
Springer Berlin Heidelberg
Keyword
Ear Surgery
Published in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08720-y