Abstract
Some difficulties may be encountered during stapedectomy, as middle ear exposure problems due to exaggerated bony overhang of the deep meatus, or short chorda tympani beside oval window exposure problems due to bulging facial nerve, promontory or overgrowth of otosclerotic bone.This study aimed to use and evaluate otoendoscopy in stapedectomy and also as a trial to overcome the possible difficulties encountered during this operation.The study was done on 5 temporal bones and 10 stapedectomy operations. The standard procedure was done using the 2.7-mm, 30° endoscope with a return to microscope when needed. Each step was done, evaluated and compared with microscopic procedure.Most of the steps, such as elevation of tympanomeatal flap, cutting stapedius tendon, fracture and removal of stapes crura were as easy to perform with the endoscope as with the microscope.However, the endoscope provided much better exposure of the middle ear without destructive steps such as removal of the bony overhang, which may lead to retraction pockets or cutting of the chorda tympani, which leads to taste disorders. Also, in difficult cases of exposure, exposure of the oval window and creating a fenestrum in it were done better by using the endoscope.However, in the presence of a bony overhang of the external meatus, application of the prosthesis was more difficult to do with the endoscope using the usual instruments. This could be overcome by using specially designed curved instruments.Endoscopic-assisted stapedectomy may replace microscopic procedure due to the superior exposure it provides alongside the lesser complications associated with this exposure.
Published Version
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