HSC Section 8_April 2017

A. J. SOOD ET AL.

Endolymphatic sac decompression was defined as complete mastoidectomy with wide exposure of the posterior fossa dura in the area of the endolymphatic sac but no incisions into the sac. Shunting procedures included mastoid shunt (opening the sac) with or without silastic. If the author reported a sac decom- pression procedure but described opening the endolymphatic sac in the surgical technique, the study was included in the mastoid shunting without silastic group. If the surgical technique was unclear, we emailed the corre- sponding author to ensure correct categorization of data. FIG. 6. Vertigo control: Forest plot for mastoid shunt with silastic with Category A/B vertigo control at a minimum of 12 months of follow-up. Statistical Analysis A meta-analysis of proportions was performed using MedCalc 12.7.0. Short-term and long-term endpoints were evaluated for the following treatment groups: 1) Current ESS procedures a. sac decompression versus mastoid shunt procedures 2) Current mastoid shunt procedures b. mastoid shunt with silastic sheeting versus mastoid shunt without silastic sheeting

Each technique was weighted according to the number of pa- tients treated. Analysis of pooled proportions was performed where appropriate. MedCalc used a Freeman Y Tukey transfor- mation (30) to calculate the weighted summary proportion under the fixed and random effects model (31). Data were presented as weighted proportions with corresponding 95% confidence in- tervals (CIs). Both the fixed effects model and the random effects model were used in this study. In addition, a W 2 test with Yates correction for continuity was applied with 2-sided (or 2-tailed) p values for the com- parison of 2 proportions from independent samples (these pro- portions being the vertigo control and hearing preservation) expressed as a percentage, as calculated from the aforemen- tioned aggregations. Complete methods are described in the Supplemental Methods Section, http://links.lww.com/MAO/A220. FIG. 8. Vertigo control: Forest plot for mastoid shunt without si- lastic with Category A/B vertigo control at a minimum of 12 months of follow-up.

RESULTS

The literature search resulted in a total of 4,262 man- uscripts/abstracts. Of these, a total of 36 manuscripts

FIG. 7. Hearing outcomes: Forest plot for mastoid shunt with silastic with hearing improved or stable at a minimum of 12 months of follow-up.

FIG. 9. Hearing outcomes: Forest plot for mastoid shunt without silastic with hearing improved or stable at a minimum of 12 months of follow-up.

Otology & Neurotology, Vol. 35, No. 6, 2014

57