An endoscopic approach to stapes surgery needs less external auditory canal wall removal than a microscopic approach

Abstract

Background

Although many advantages of endoscopic stapes surgery have been reported, there is little objective data on whether it provides better visualization than the microscopic approach.

Objectives

To evaluate and compare audiological results, external auditory canal wall removal area, and adverse event rates between endoscopic and microscopic stapes surgery.

Material and methods

Data from patients who received stapedotomy were collected. Pre and postoperative audiometry, procedure-related parameters, and adverse events were analyzed in conventional microscopic and endoscopic groups.

Results

There were no differences in procedure time or postoperative hearing between the endoscopic and microscopic surgery groups. The mean procedure times were 87.3 ± 18.9 min in the endoscopic group and 79.9 ± 23.5 min in the microscopic group. The mean postoperative air-bone gaps were 10.9 ± 8.3 dB in the endoscopic group and 10.5 ± 7.8 dB in the microscopic group. There were no differences in the rate of sensorineural hearing loss, postoperative pain, facial palsy, vertigo, or dysgeusia between the two groups. The bony removal area of the posterosuperior external auditory canal wall measured by two observers was significantly less in the endoscopic group than in the microscopic group.

Conclusions

Endoscopic stapedotomy needed less external auditory canal wall removal and showed similar audiological outcomes to microscopic stapedotomy.

Chinese Abstract

背景：虽然已经报道了内窥镜镫骨手术的许多优点, 但关于它是否提供比显微镜方法更好的可视化, 其客观数据少之又少。

目的：评估和比较内窥镜和显微镜镫骨手术之间的听力学结果、外耳道壁切除面积和不良事件发生率。

材料和方法：收集了接受镫骨切开术患者的数据。分析了常规显微镜组和内窥镜组的手术前后听力测试、手术相关参数和不良事件。

结果：内窥镜手术组和显微镜手术组之间在手术时间或术后听力方面无差异。 内窥镜组平均手术时间为 87.3±18.9 分钟, 而显微镜组为 79.9±23.5 分钟。 平均术后气骨间隙, 内窥镜组为10.9±8.3 dB, 显微镜组为10.5 ±7.8 dB。 两组之间没有感觉神经性听力损失、术后疼痛、面神经麻痹、眩晕或味觉障碍发生率方面的差异。 由两名观察者测量外耳道后上壁去骨区, 内窥镜组明显低于显微镜组。

结论：内窥镜镫骨切开术只需要较少的外耳道壁去除, 并具有与显微镜镫骨切开术相似的听力学结果。

Keywords:

• Stapedotomy
• endoscopic surgery
• conductive hearing loss
• hearing
• complication

Disclosure statement

No potential conflict of interest was reported by the author(s).