SynthesisClinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery2026
Efficacy of Multiple Interventions for Moderate to Large Traumatic Tympanic Membrane Perforations: A Systematic Review and Network Meta-Analysis.
Synthesis in Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to evaluate the comparative efficacy of various therapeutic interventions for moderate to large traumatic tympanic membrane perforations (TTMP) through a network meta-analysis. Different treatment strategies were compared with respect to tympanic membrane healing rate, healing time, hearing improvement and incidence of otorrhea, providing evidence-based support for clinical decision-making.
methodsA systematic search of multiple databases, including PubMed, Web of Science and Embase, was conducted to identify randomised controlled trials (RCTs) involving patients with moderate to large TTMP. A Bayesian hierarchical model was utilised to perform the network meta-analysis, assessing the relative effects of different interventions. Effect sizes, including relative risk (RR) and mean difference (MD), were computed for each intervention, with all analyses reported alongside 95% confidence intervals (CIs).
resultsA total of 13 studies involving 1285 patients were included in the analysis. The findings suggested that fibroblast growth factor-2 (FGF-2) demonstrated the highest efficacy in enhancing tympanic membrane healing rates and reducing healing times, particularly when combined with gelfoam patching. Additionally, ofloxacin otic solution appeared to have positive effects on healing rates. Conversely, edge approximation ranked lowest among all interventions, suggesting limited effectiveness in treating moderate to large perforations.
conclusionThis network meta-analysis provides hypothesis-generating evidence that active intervention may be superior to watchful waiting for moderate to large TTMPs. FGF-2-based strategies, particularly when combined with physical scaffolds, show promise in improving healing outcomes. Additionally, ofloxacin otic solution may offer benefits in controlling local infections and optimising the middle ear microenvironment. In contrast, edge approximation appears less effective in this population. However, given the geographic homogeneity, limited number of studies and methodological constraints, these findings should be considered exploratory and require confirmation in large-scale, multicentre RCTs with standardised protocols and robust blinding procedures.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.