A Mate-analysis About The Efficacy And Safety Of The Balloon Dilatation Of Eustachian Tube In The Treatment Of Chronic Otitis Media With Effusion

Objective: To explore the efficacy and safety of the balloon dilatation of eustachian tube(BDET)in the treatment of chronic otitis media with effusion(COME)by means of Meta-analysis,and to provide evidence-based medical evidence for the clinical practice of COME by comparing the differences between different treatment methods of COME.Methods: The published,ongoing,unpublished and unpublished studies related to the subject were retrieved from Chinese and international databases.Manual retrieval of conference literature,relevant magazine literature,references and other gray literature.The time interval of literature publication is from January 2009 to March 2020,and the retrieval language is limited to Chinese or English.According to the inclusion and exclusion criteria,the relevant literature was screened.Two researchers evaluated the quality of the included literature,extracted the relevant data from the original research,and used Revman 5.2 software for meta-analysis.Results: According to the characteristics of different intervention measures and whether there is a control group or not,the original research was divided into five subgroups.The quantitative meta-analysis was carried out for the Ⅰ-Ⅳ research and the descriptive analysis was carried out for the Ⅴ research.The results of Meta-analysis showed that the overall response rate(ORR)of BDET in the treatment of COME was higher than that of traditional therapy,and the difference was statistically significant.(I: RR = 1.26,95% CI(1.17-1.35),P < 0.00001 Ⅱ: OR = 5.66,95% CI(3.31~ ~ 9.76),P<0.00001)After intervention,ETDQ-7 scores of patients with Ⅲ and Ⅳ were significantly lower than those before operation(Ⅲ: MD =-2.36,95% CI(-2.84-1.88),P < 0.00001 Ⅳ: MD =-1.69,95% CI(-2.92-0.45),P = 0.007).In terms of surgical safety,none of the included studies had serious adverse events related to BDET.In group II,the adverse events of BDET were significantly lower than those of grommet insertion(GI)/ tympanic paracentisis(TP)group(OR = 0.17,95% CI(0.08-0.38),P < 0.00001).Conclusion: 1.BDET is an effective treatment of COME.2.Compared with GI/ TP group,patients receiving BDET had more benefits.3.The recommended intensity and evidence quality of BDET for COME is 1B.