Endoscopic middle ear surgery: First steps in a third level hospital

Abstract

Introduction: The use of endoscopic ear surgery (EES) is a worldwide tendency. It gives a wider vision, better magnification and depthness of the surgical field. However, there’re still some doubts related to its results in our daily surgical settings. The purpose of this study is to describe patients diagnosed in our center with otologic surgical pathology who were treated through an endoscopicc approach. Methods:Retrospective cohort study of patients undergoing endoscopic ear surgery during the period from January 2015 to March 2018. Information related to epidemiological features, type of intervention, surgical operation room time, and type of reconstruction, complications, and comparing audiometry results before and after intervention was documented. Results:48 patients were operated, in which a total of 23 myringoplasties (48%), 16 tympanoplasties (33%) and 9 stapedectomies (19%) were performed. An optimal surgical closure of the perforation was achieved in 17/23 myringoplasties (74%), with a mean operation time (OT) of 88 minutes and from a pre PTA 27.5 dB to a follow up of 19.5 dB. In tympanoplasties , pre PTA went from 45.7 dB to a 30.6dB and OT of 106 minutes. Stapedectomies showed an improvement from 46.6 dB to 20 dB with an OT of 81 minutes. No major postoperative complications were observed. Conclusions: EES is a reproducible and reliable technique showing new benefits compared to conventional otologic approaches and similar complications. EES has a short learning curve allowing it to be used as an additional element in training programs during the otolaryngology residency, and in our daily basis surgical routine.