Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery?

Abstract

Background: Microscopic stapedotomy is very successful and has long history, but it still has some constraints. Thus, otoendoscopy is increasingly popular nowadays.

Aims/Objectives: The retrospective review study was to investigate the role of endoscopic laser stapedotomy in treating patients with otosclerosis.

Materials and methods: Seventeen patients who received endoscopic laser stapedotomy from April 2014 to July 2017 were enrolled and compared to 13 patients who had microscopic stapedotomy from February 2009 to March 2012. The anatomical structures, operative time, and postoperative hearing outcomes were assessed in two groups. Relation between external acoustic canal and operative time was also analyzed.

Results: Using an endoscope, the operative field was clear, with easily identified anatomy, without need to sacrifice bony structures. The operative time was significantly longer in the endoscopic group in 2014 and decreased in the following years. There was no significant difference of hearing improvements between the two groups. There was a weak correlation between the width of the external auditory canal and the operative time.

Conclusions and significance: Fully endoscopic stapes surgery is a feasible and safe surgical technique and results in satisfactory hearing outcomes. However, surgeons take longer to master the technique and to achieve shorter endoscopic operative times.

Chinese abstract

背景：显微镜下镫骨切开术非常成功且历史悠久, 但仍存在一些局限性。因此, 耳内镜现在越来越流行。

目标/目的：该回顾性研究旨在探讨内镜激光镫骨切开术对治疗耳硬化症的作用。

材料和方法：纳入从2014年4月至2017年7月接受内镜激光镫骨切开术的17例患者, 并与2009年2月至2012年3月接受显微镜下镫骨切开术的13例患者进行比较。对两组的解剖结构、手术时间和术后听力结果均进行了评估。还分析了外耳道与手术时间长度的关系。

结果：使用内镜, 手术视野清晰, 易于识别解剖结构, 无需牺牲骨结构。 2014年内镜组手术时间明显较长, 随后几年渐短。两组听力改善无显著差异。外耳道宽度与手术时间长度之间存在弱相关。

结论和意义：全内镜镫骨手术是一种可行且安全的外科技术, 可产生令人满意的听力结果。然而, 外科医生需要较长的时间来掌握该技术并取得较短的内镜手术时间。

Keywords:

• Endoscope
• stapedotomy
• otosclerosis
• microscopic ear surgery

Disclosure statement

No potential conflict of interest was reported by the authors.