Transcanal endoscopic ear surgery for traumatic ossicular injury

Abstract

Background: Transcanal endoscopic ear surgery (TEES) for traumatic ossicular injuries (TOI) is not well studied.

Objectives: To analyze the treatment outcomes of TEES for TOI.

Material and methods: Retrospective case review of fifteen patients (15 ears) with TOI was performed. The patients underwent an either ossiculoplasty or stapes surgery according to status of the ossicular chain using ear endoscopes. Postoperative audiometric results and complications were analyzed.

Results: All subjects demonstrated improvement in their air conduction threshold and air-bone gap (ABG). The mean preoperative air conduction threshold and ABG were 55.3 dB (SD: 12.8) and 33.0 dB (SD: 9.5), respectively. Postoperatively, the air conduction threshold and ABG significantly improved to 28.1 dB (SD: 16.0) and 8.1 dB (SD: 4.5), respectively. Separation of the incudomalleolar joint accompanied by defect of the tegmen, which was not discernible on preoperative imaging, could be identified without additional incision or mastoidectomy. No patients experienced complications or a sensorineural hearing loss. Conversion to open approach was not necessary for any of the 15 procedures performed.

Conclusion and significance: TEES for TOI yielded favorable audiometric results without any complication. TEES can provide an alternative method to manage TOI with the advantage of avoidance of skin incisions and mastoidectomy.

Chinese abstract

背景：关于经外耳道内窥镜耳外科（TEES）治疗创伤性听骨损伤（TOI）的研究不多。

目的：分析TEES治疗TOI的疗效。

材料与方法：回顾性分析15例（15耳）TOI患者的临床资料。根据听骨链的情况, 采用耳内窥镜对患者进行听骨成形术或镫骨手术。分析术后测听结果及并发症。

结果：所有受试者的气导阈值和气骨间隙（ABG）均有改善。术前平均气传导阈值为55.3 dB（SD:12.8）, 平均ABG为33.0 dB（SD:9.5）。术后空气传导阈值和ABG分别提高到28.1 dB（SD:16.0）和8.1 dB（SD:4.5）。术前影像检查不清楚的砧镫关节分离伴被盖缺损, 无需附加切口或乳突切除就能被鉴定出来。没有患者出现并发症或感觉神经性听力损失。15个手术中, 没有一个需要换成开放手术。

结论及意义：用TEES治疗TOI, 听力测量结果良好, 无并发症。TEES可避免皮肤切口和乳突切除, 为TOI的治疗提供一种新的方法。

Keywords:

• Endoscopic ear surgery
• trauma
• ossicular injuries
• ossiculoplasty
• stapes surgery

Disclosure statement

The authors report no conflict of interest.