Abstract
Objective
Canal wall up (CWU) and canal wall down (CWD) mastoidectomies represent the most common
cholesteatoma surgical techniques. In this meta-analysis, we compare the postoperative
quality of life (QoL) in patients treated with either CWU or CWD mastoidectomy.
Methods
A literature search was conducted in the following three electronic databases: Medline/PubMed,
ScienceDirect, and Google Scholar. Articles were assessed for eligibility in accordance
with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
statement and data were extracted independently by two authors. Biases assessment
was conducted for each study according to the Methodological Items for Non-Randomized
Studies (MINORS) tool. Meta-analysis was performed for postoperative QoL following
CWU versus CWD mastoidectomy.
Results
Our systematic review included four studies that met the inclusion criteria, three
prospective cohort studies, and one retrospective cohort study. The meta-analysis
did not favor treatment with one of the two surgical techniques. Postoperative QoL
did not show a statistically significant difference between CWU and CWD mastoidectomies
(p>0.05).
Conclusion
Our systematic review and meta-analysis results indicate that QoL is not statistically
significantly better among patients who underwent CWU mastoidectomies when compared
with CWD. The trend of selecting CWU over CWD mastoidectomies in selected cases -
for QoL purposes - is not always based on evidence-based data. The statistically insignificant
difference between the two surgical techniques suggests that an initial more radical
approach might prevent patients from further surgeries, without affecting postoperative
QoL.
Keywords
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Article info
Publication history
Published online: February 04, 2023
Accepted:
January 24,
2023
Received:
November 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
