Abstract
Objective:The main objectives of the present study were to compare the surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery.Methods:Sixty-one patients who underwent the stapes surgery with the endoscopic and microscopic approach between January 2012-November 2018 were included in the study. Patients were divided into two groups as a Group-I (endoscopic) and Group-II (microscopic). The audiometric measurements, duration of surgery, intraoperative findings and complications were recorded and evaluated retrospectively.Results:Mean operative time for the Group-I and II was 45.1±8.4 minutes and 48.7±5.6 minutes, respectively (p>0.05). The preoperative and postoperative average air-bone gap in the Group-I was 27.8±7.2 dB and 8.7±3.4 dB and these values in Group-II were 30.2±5.1 dB and 7.4±4.8 dB, respectively (p<0.001). The requirement of chorda tympani nerve manipulation and scutum curettage were significantly less in Group-I as compared Group-II (p<0.05). Dysgeusia and postoperative pain were observed significantly higher ratios in Group-II relative to Group-I (p<0.05). There was no significant difference between endoscopic and microscopic approach in stapes surgery in terms of difficulty of prosthesis insertion (p>0.05).Conclusion:Endoscopic stapes surgery provides comparable audiological outcomes, shorter operative times, fewer complications rates, and more minimally invasive surgery, relative to the microscopic approach.
Highlights
Otosclerosis, which is characterized by bone resorption and sclerotic bone formation in temporal bone and might be resulting in either conductive or mixed type hearing loss, was first described by1
Of the 20 of 29 patients were operated by the first author and the remaining nine patients were operated by the other surgeon
The temporal bone computed tomography was obtained from all patients to assure whether that they have any other condition causing a conductive type of hearing loss such as tympanosclerosis, ossicular dislocation or superior semi-circular canal dehiscence syndrome
Summary
Otosclerosis, which is characterized by bone resorption and sclerotic bone formation in temporal bone and might be resulting in either conductive or mixed type hearing loss, was first described by. Valsalva.[1] In stapes surgery (SS); different surgical techniques, approaches and prostheses in order to restore sound transmission have been described. A small fenestration stapedotomy proposed by Ugo Fish is a widely accepted procedure for otosclerosis surgery.[3] Poe has first described the laser-assisted endoscopic stapes surgery (ESS) in 2000, soon after Tarabichi reported preliminary results of ESS in 1999.4,5 Recently endoscopes as a primary or auxiliary intensively started to be used in SS.[6,7,8] The endoscopes provide excellent and panoramic visualization of the complex middle ear anatomy and stapedial structures.[9] microscopic transcanal or endaural approach is the most preferred technique in SS currently. Authors comprehensively compared the surgical and functional outcomes of endoscopic and microscopic approach in SS
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