Tympanic Cavity Packing in Tympanoplasty Type 1: A Meta-Analysis

Area of Science:

• Otolaryngology
• Surgical Techniques
• Evidence-Based Medicine

Background:

• Tympanic cavity packing is a standard myringoplasty step.
• Packing materials can cause adverse effects.
• The necessity of packing in Type 1 myringoplasty requires evaluation.

Purpose of the Study:

• To compare outcomes of Type 1 myringoplasty performed with versus without tympanic cavity packing.
• To assess the impact of packing on graft uptake, functional success, and postoperative complications.
• To evaluate procedural efficiency and hearing outcomes based on packing status.

Main Methods:

• A meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs was conducted.
• Searches were performed across PubMed, Cochrane, Embase, Google Scholar, and clinicaltrials.gov.
• Data on graft uptake, functional success, air-bone gap closure, procedure time, and aural fullness were analyzed.

Main Results:

• No significant differences in graft uptake (RR 1.01) or functional success (RR 1.05) were observed between groups.
• The no-packing group showed significantly better air-bone gap closure at 1 and 3 months post-surgery.
• No-packing resulted in shorter procedure times and reduced postoperative aural fullness (RR 0.35).

Conclusions:

• Type 1 tympanoplasty yields comparable graft uptake and functional success rates regardless of packing.
• Performing myringoplasty without packing offers advantages including reduced procedure duration, earlier hearing improvement, and less postoperative discomfort.
• The findings support considering no-packing techniques in Type 1 tympanoplasty.