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Chorda tympani injury during endoscopic versus microscopic stapes surgery: a randomized controlled clinical trial. Eur Arch Otorhinolaryngol 2023; 280:689-693. [PMID: 35871441 PMCID: PMC9849188 DOI: 10.1007/s00405-022-07550-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/07/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to compare the incidence of chorda tympani nerve (CTN) injury between endoscopic and microscopic stapes surgery. METHODS This randomized controlled clinical trial included 88 patients who were randomly divided into two groups: endoscopic stapedotomy group (n = 44) and microscopic stapedotomy group (n = 44). The incidence of chorda tympani nerve (CTN) injury after surgery was determined by both subjective taste testing and chemical taste tests, before and after surgery. The results were compared between the two groups. RESULTS The total number of patients who were identified as having CTN affection (based on the chemical testing) was 16 out of 88 (18.2%). The incidence was significantly lower in the endoscopic group (n = 2) than the microscopic group (n = 14) (p = 0.019). CONCLUSION Altered taste as a result of iatrogenic CTN injury can affect the patients' quality of life. Endoscopic ear surgery offers better visualization, less need for extensive manipulation of the chorda tympani, and consequently decreased incidence of CTN injury.
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Molinari G, Fernandez IJ, Melchiorri C, Reale M, Bonali M, Presutti L, Lotto C, Lucidi D. “Hot” vs “Cold” endoscopic stapes surgery: a matched case–control study. Eur Arch Otorhinolaryngol 2022; 280:2257-2263. [PMID: 36380092 PMCID: PMC10066065 DOI: 10.1007/s00405-022-07739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose
To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with CO2 fiber laser or microdrill.
Methods
A case–control study was performed. All consecutive cases of CO2 fiber laser ESS operated at a single center during the period 2017–2020 (case group) were matched to a control group of patients operated by traditional technique, according to year of surgery, preoperative mean air–bone gap, sex and age. Audiological data from preoperative and postoperative examinations and complication rates were compared.
Results
46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p < 0.05), except for the AC threshold at 8 kHz. Similar rates of complications were found in the two groups.
Conclusion
This study is the first to compare hearing results and complications between CO2 fiber laser and microdrill in ESS. Our results demonstrated similar functional outcomes between the two groups, confirming ESS as safe and effective, regardless of the technique used.
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Chen CK, Kuo CL, Weng YT, Hsieh LC. Endoscopic transcanal transtympanic myringoplasty vs. endoscopic transcanal tympanoplasty: 1-year follow-up study. J Chin Med Assoc 2022; 85:1017-1023. [PMID: 35818928 DOI: 10.1097/jcma.0000000000000777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Endoscopic transcanal transtympanic myringoplasty (ETTM) is a relatively easier technique than endoscopic transcanal tympanoplasty (ETT) for repairing tympanic membrane perforations. No studies have compared the outcomes of these two procedures with tragal perichondrium after 1-year. Furthermore, there is no evidence-based stratification according to variations in perforation size in endoscopic ear surgery. Therefore, we compared the 1-year outcomes of ETTM and ETT stratified according to perforation size. METHODS Patients who underwent ETT and ETTM to repair eardrum perforations with a tragal perichondrium graft were identified. Pure-tone audiometric tests and otoscopic examination were performed to assess hearing outcomes and perforation sizes both preoperatively and at least 1 year postoperatively. RESULTS In total, 158 patients (159 ears) were included. ETT was performed on 83 ears, and ETTM was performed on 76 ears. The ETTM procedure time was 10-minutes shorter than that for ETT ( p < 0.001). Perforation size was significantly correlated with graft take-rate. For large perforations, the ETT success rate was significantly higher than that of ETTM (91.7% vs. 78.9%). Success rates for small-medium perforations were comparable for both methods ( p > 0.05). However, for medium perforations, the graft take-rate of ETT reached a plateau after 6 months, while that of ETTM gradually declined during the 12-month follow-up. Both groups had a comparable mean postoperative air-bone gap gain ( p = 0.666). CONCLUSION ETTM is suitable for repairing small perforations, whereas ETT is preferred for large perforations. Both methods, and particularly ETTM, should be employed cautiously for medium perforations.
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Affiliation(s)
- Chin-Kuo Chen
- Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
| | - Chin-Lung Kuo
- Department of Otolaryngology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Ting Weng
- Schcool of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Chun Hsieh
- Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City, Taiwan, ROC
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Endoscopic Ear Surgery: Our Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:263-271. [PMID: 36032880 PMCID: PMC9411338 DOI: 10.1007/s12070-020-02042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022] Open
Abstract
Endoscopes are presently used as an adjunct to microscopic surgery for better visualization of hidden areas of middle ear or they are used as a primary modality replacing the microscopes. We performed primary endoscopic ear surgery at a tertiary care center to evaluate the scope of endoscopic ear surgeries and to evaluate the anatomical, functional and quality of life outcomes. We evaluated 103 cases of which included patients with chronic otitis media mucosal disease (64), chronic otitis media squamous disease (29), otosclerosis (6), and benign ear tumors (4). In our study, the structural and functional outcomes of endoscopic ear surgeries were comparable to microscopic techniques however it conferred superior patient related outcomes of cosmesis, post-operative pain and early return to daily routine. Thus endoscopic ear surgery is a minimally invasive alternative option to microscopic techniques in the field of otology.
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Dutta M, Kundu S, Ghosh B, Ghosh P. Perspectives and early experience on endoscopic stapedotomy from a group of "traditional school" otologists. EAR, NOSE & THROAT JOURNAL 2022:1455613221078183. [PMID: 35259947 DOI: 10.1177/01455613221078183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: This paper evaluates endoscopic stapedotomy from the perspectives of a group of 3 surgeons, each of whose experience in endoscopic and microscopic stapedotomy is 3 years and more than 12 years, respectively.Methods: Thirty-four patients clinically diagnosed with stapedial otosclerosis were alternately assigned for unilateral, microscope- and endoscope-assisted stapedotomy following the selection criteria given. Results were evaluated with predetermined epidemiologic, preoperative, perioperative, and postoperative outcome parameters.Results: The microscope group had 12 ears with otosclerosis and the endoscope-assisted group 14. Ears found to have conditions other than otosclerosis at surgery, and patients lost to follow-up were excluded. Apart from the operative time, the difference in the results of none of the parameters was statistically significant in the two groups. The average operative times for microscope- and endoscope-assisted stapedotomy were 63 minutes and 86.5 minutes, respectively, the difference being statistically significant (P < .001).Conclusions: From the perspectives of otologists in differential positions in the learning curve for microscope- and endoscope-assisted stapedotomy, there were no statistically significant differences between the two procedures in the execution of the steps to achieve "adequate surgical exposure" and in postoperative outcomes, except for operative time.
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Affiliation(s)
- Mainak Dutta
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, West Bengal, India
| | - Sohag Kundu
- Department of Otorhinolaryngology and Head-Neck Surgery, Rampurhat Government Medical College and Hospital, Birbhum, West Bengal, India
| | - Bhaskar Ghosh
- Department of Otorhinolaryngology and Head-Neck Surgery, Rampurhat Government Medical College and Hospital, Birbhum, West Bengal, India
| | - Pramit Ghosh
- Indian Council of Medical Research - Regional Medical Research Centre, Dibrugarh, Assam, India
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6
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Different approach for surgery of stapes: Comparison microscopic and endoscopic approach. Am J Otolaryngol 2022; 43:103242. [PMID: 34543947 DOI: 10.1016/j.amjoto.2021.103242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/28/2021] [Accepted: 09/10/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to discuss the different surgical approach, functional hearing results, which are applied to patients operated with a diagnosis of otosclerosis in our clinic. METHODS This study includes 92 ears of 84 patients who were operated with the diagnosis of otosclerosis. Air bone gap was calculated before and after the operation in all patients. In addition, endoscopic and microscopic methods can be compared and statistically tested whether there is a difference in air bone gap averages and surgical success. Of the 92 ears operated, 56 were right (61%) and 36 were left (39%). Otosclerosis was detected bilaterally in 61 patients (73%) and unilaterally (27%) in 23 patients. The duration of follow-up ranges from 6 month to ten years, on average 28 months. RESULTS In the microscopic operation group, the air pathway measurement was mean 55.58 dB preoperatively and mean 38.42 dB postoperatively, with a mean decrease of 17.16 dB determined. The decrease between the preoperative and postoperative air pathway values was determined to be statistically significant (t:7.20, p < 0.001). In the microscopic operation group, the air-bone gap value was mean 30.50 dB preoperatively and fell by 15.90 dB to 14.60 dB postoperatively. In the endoscopic group, the air-bone gap value was mean 32.32 dB preoperatively and fell by 13.51 dB to 18.81 dB postoperatively. CONCLUSIONS Stapes surgery is a successful method with high success rate and low complication rates in the treatment of otosclerosis. The success rate of endoscopic and microscopic stapes surgery is similar. However, endoscopic stapes surgery is specific and difficult otological surgery that must be performed by surgeons specialised on this subject.
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Hoskison EE, Harrop E, Jufas N, Kong JHK, Patel NP, Saxby AJ. Endoscopic Stapedotomy: A Systematic Review. Otol Neurotol 2021; 42:e1638-e1643. [PMID: 34267093 DOI: 10.1097/mao.0000000000003242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Stapes surgery has evolved from its origins in 1956. Microscopic assisted stapedotomy remains the most common technique but the introduction of endoscopic ear surgery has led to some units using this new approach. The endoscope delivers a wide angled, contextual view of the stapes, and associated pathology. This systematic review provides a critical analysis of the current published endoscopic data, allowing comparison to the established microscopic technique. DATA SOURCES Six databases (PubMed, Medline, Cochrane database, AMED, EMBASE, and CINAHL) were searched for studies within the last 10 years. STUDY SELECTION AND DATA EXTRACTION English language articles including 5 or more cases were included. Primary outcomes included audiological results and reported complications. Data was extracted according to PRISMA guidelines. RESULTS Thirteen papers were identified comprising 361 endoscopic stapes surgeries. Postoperative temporary facial nerve weakness was reported in 3 patients (0.8%) which all resolved within 4 weeks. Chorda tympani injury occurred in 21 cases (5.8%) and vertigo in 61 (16.9%). The audiometric outcomes of endoscopic stapes surgery were available for 259 patients and showed air bone gap closure rates of 71.4% (0-10 dB), 25.9% (11-20 dB), 2.3% (21-30 dB), and 0.4% (>30 dB). CONCLUSIONS Endoscopic stapes surgery has similar audiometric outcomes compared to the traditional microscopic approach with air bone gap closure values of <20 dB in 97.3% of cases. However, the complication rates of chorda tympani damage, postoperative dysguesia, and tympanic membrane perforation for endoscopic stapes surgery are high. Caution should therefore be taken before undertaking stapes surgery with the endoscopic technique. Further studies are required to prove superiority over well established existing microsurgical methods.
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Affiliation(s)
- Emma E Hoskison
- Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital
| | - Elizabeth Harrop
- Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital
| | - Nicholas Jufas
- Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney
- Sydney Endoscopic Ear Surgery ('SEES') Research Group
- Discipline of Surgery, Sydney Medical School, University of Sydney, Australia
| | - Jonathan H K Kong
- Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital
- Sydney Endoscopic Ear Surgery ('SEES') Research Group
- Discipline of Surgery, Sydney Medical School, University of Sydney, Australia
| | - Nirmal P Patel
- Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney
- Sydney Endoscopic Ear Surgery ('SEES') Research Group
- Discipline of Surgery, Sydney Medical School, University of Sydney, Australia
| | - Alexander J Saxby
- Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital
- Sydney Endoscopic Ear Surgery ('SEES') Research Group
- Discipline of Surgery, Sydney Medical School, University of Sydney, Australia
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Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? : Post-operative dysgeusia after EStS. Eur Arch Otorhinolaryngol 2021; 279:2269-2277. [PMID: 34236486 DOI: 10.1007/s00405-021-06908-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS. METHODS Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale. RESULTS The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%). CONCLUSION Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS.
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Yancey KL, Manzoor NF, Rivas A. Endoscopic Stapes Surgery: Pearls and Pitfalls. Otolaryngol Clin North Am 2020; 54:147-162. [PMID: 33153730 DOI: 10.1016/j.otc.2020.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The endoscopic approach to stapes surgery affords unique advantages but is not without its specific challenges. The following reviews the equipment and surgical steps required to perform endoscopic stapes surgery safely and effectively, highlighting tips and potential points of failure through a series of case examples.
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Affiliation(s)
- Kristen L Yancey
- Department of Otolaryngology-Head and Neck Surgery, The Bill Wilkerson Center for Otolaryngology & Communication Sciences, 7209 Medical Center East South Tower, 1215 21st Avenue South, Nashville, TN 37232-8605, USA.
| | - Nauman F Manzoor
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals, ENT Institute, Case Western Reserve University, 11100 Euclid Avenue, Stop Mail: LKSD 5045, Cleveland, OH 44106, USA
| | - Alejandro Rivas
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals, ENT Institute, Case Western Reserve University, 11100 Euclid Avenue, Stop Mail: LKSD 5045, Cleveland, OH 44106, USA
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Bartel R, Sanz JJ, Clemente I, Simonetti G, Viscacillas G, Palomino L, Asarta I, Lao X. Endoscopic stapes surgery outcomes and complication rates: a systematic review. Eur Arch Otorhinolaryngol 2020; 278:2673-2679. [PMID: 33001293 DOI: 10.1007/s00405-020-06388-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE These days, the gold standard procedure for otosclerosis treatment is stapes surgery. The endoscopic approach of the procedure is gaining popularity as endoscopic ear surgery develops across the globe. The main objective of this study is to gather and compile well-documented and reliable data regarding surgical outcomes for the endoscopic approach to stapes surgery up to this date. MATERIALS AND METHODS Publications in English were searched in the PUBMED/MEDLINE database and were systematically reviewed. A total of 16 articles were reviewed according to the inclusion criteria, obtaining a total of 573 patients managed surgically for otosclerosis, using an endoscopic approach. Data were systematically extracted and compared across variables. RESULTS Data were obtained as follows: mean age of 43 years; female proportion of 60%; 3 mm endoscope diameter of 51%, 4 mm of 39%; titanium piston-type prostheses of 52% and Teflon of 48%; length of the prosthesis (mode) was 4.5 mm; 0.6 mm diameter of the piston of 81% and 0.4 mm of 19%; mean surgical time was 55 min. Hearing results, mean preoperative air-bone gap (ABG) 31 dB; mean postoperative ABG 9 dB; ABG improvement of 22 dB; an ABG closure rate to 20 dB or less of 92% and an ABG closure rate to 10 dB or less of 77%. Complication rates: intraoperative tympanic membrane perforation of 5%; postoperative vertigo of 11%; postoperative dysgeusia of 10%; reported a postoperative neurosensorial hearing loss of 0.2%; reported gusher phenomenon of one case (0.2%). CONCLUSION Endoscopic stapes surgery is completely achievable using 0º angle and 4-mm-diameter sinus surgery endoscope. Instrument availability should not be an obstacle to the development of this type of surgery in any otolaryngology department. Audiological outcomes are comparable to microscopic approaches.
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Affiliation(s)
- Ricardo Bartel
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain. .,Otology Research Group of Young Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.
| | - Juan Jose Sanz
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Ignacio Clemente
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Gabriela Simonetti
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Guillem Viscacillas
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Laura Palomino
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Isabel Asarta
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
| | - Xavier Lao
- Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
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A comparison between endoscopic and microscopic approaches for stapes surgery: a systematic review. The Journal of Laryngology & Otology 2020; 134:398-403. [DOI: 10.1017/s0022215120000821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AbstractObjectivesTo evaluate the surgical techniques, approaches, audiological outcomes and complications of endoscopic stapes surgery.MethodsSystematic searches of the literature were performed in PubMed, Web of Science and Scopus databases, to identify studies of patients who underwent stapes surgery using endoscopic approaches and studies reporting objective post-operative hearing outcomes. The following information was extracted: surgery duration, complications, surgical technique and audiometric results.ResultsFourteen studies were selected for appraisal, which included a total of 282 ears subjected to endoscopic stapes surgery. Endoscopic stapes surgery seems to provide adequate visualisation of the middle-ear structures, thereby allowing less invasive surgery and potentially equivalent audiological outcomes as compared with a traditional microscopic approach. Other advantages of endoscopic stapes surgery include decreased surgery time, a reduced need for drilling, and auditory results comparable to those of microscopic techniques.ConclusionStudies have shown that endoscopic stapes surgery has similar surgical and functional advantages as compared with microscopic surgery.
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Demir E, Çeliker M, Balaban GA, Dursun E. Tympanomeatal flap creation in endoscopic stapedotomy: cautery vs. cold instrumentation. Eur Arch Otorhinolaryngol 2020; 277:1061-1066. [PMID: 32048030 DOI: 10.1007/s00405-020-05847-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/04/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Bleeding is one of the most challenging issues for surgeons performing endoscopic stapedotomy. During creation and elevation of the tympanomeatal flap (TMF) prevention or control of bleeding greatly facilitates the safety and comfort in the next steps of the surgery. The aim of this study was to compare the effects of cautery versus cold instrumentation during creation of TMF at endoscopic stapedotomy surgery. METHODS We investigated 15 patients TMF created with cautery and 14 patients with cold instrument, and compared bleeding scores, operation time, postoperative hearing, pain and complications between groups. RESULTS The mean bleeding score was significantly lower in cautery incised patients compared to cold instrument patients (1.2 ± 0.9 vs. 2.3 ± 1, p = 0.005). Mean duration of surgery was also significantly shorter in cautery used patients (35.3 ± 6.8 vs. 48.8 ± 9.2 min, p < 0.001). There was no significant difference between postoperative pain, complications, wound healing, and auditory outcomes. CONCLUSIONS Cautery may be a better choice for the creation of TMF in endoscopic stapedotomy surgery due to reduced bleeding, shorter operation time and increased comfort without causing any complications.
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Affiliation(s)
- Emine Demir
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Sehitler Street, No: 74, 53020, Rize, Turkey.
| | - Metin Çeliker
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Sehitler Street, No: 74, 53020, Rize, Turkey
| | - Gökçe Aydın Balaban
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Sehitler Street, No: 74, 53020, Rize, Turkey
| | - Engin Dursun
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Sehitler Street, No: 74, 53020, Rize, Turkey
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Koukkoullis A, Tóth I, Gede N, Szakács Z, Hegyi P, Varga G, Pap I, Harmat K, Németh A, Szanyi I, Lujber L, Gerlinger I, Révész P. Endoscopic versus microscopic stapes surgery outcomes: A meta‐analysis and systematic review. Laryngoscope 2019; 130:2019-2027. [PMID: 31714605 DOI: 10.1002/lary.28353] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 08/14/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Alexandros Koukkoullis
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - István Tóth
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - Noémi Gede
- Institute for Translational Medicine, Szentágothai Research Centre University of Pécs Medical School Pécs Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Szentágothai Research Centre University of Pécs Medical School Pécs Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre University of Pécs Medical School Pécs Hungary
- First Department of Medicine University of Szeged Szeged Hungary
- Momentum Gastroenterology Multidisciplinary Research Group Hungarian Academy of Sciences–University of Szeged Szeged Hungary
| | - Gábor Varga
- Department of Oral Biology Semmelweis University Budapest Hungary
| | - István Pap
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - Kinga Harmat
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - Adrienn Németh
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - István Szanyi
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - László Lujber
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - Imre Gerlinger
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
| | - Péter Révész
- Department of Otorhinolaryngology–Head and Neck Surgery University of Pécs Medical School Pécs Hungary
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14
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Hall AC, Mandavia R, Selvadurai D. Total endoscopic stapes surgery: Systematic review and pooled analysis of audiological outcomes. Laryngoscope 2019; 130:1282-1286. [PMID: 31566754 DOI: 10.1002/lary.28294] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/15/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study evaluates the current evidence base for total endoscopic stapes surgery, specifically to establish current efficacy and safety of the technique within clinical practice. DATA SOURCES A systematic review of the literature on endoscopic stapes surgery was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. A comprehensive search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials database for relevant publications for all available dates with appropriate Medical Subject Headings search criteria in January 2018. STUDY SELECTION Out of the 160 articles identified in the search, 14 met the inclusion criteria for further analysis. Four of these were level III and 10 level IV evidence. DATA EXTRACTION A pooled patient population of 314 individuals was analyzed. DATA SYNTHESIS Documented postoperative air bone gap closure to within 20 dB was found in 95.3% of individuals (285 patients). Facial nerve palsy (temporary) occurred in three patients (0.6%), with all recovering. No total sensorineural hearing losses were recorded, but two moderate sensorineural hearing losses occurred (0.6%). Perilymph fistula was noted on four occasions (1.3%). Chorda tympani trauma was documented in 3.5% of cases, with taste disturbance documented in 13 patients (5%). CONCLUSIONS Our pooled analysis uses the current published evidence to establish the complication rate and audiological outcome for the endoscopic approach to stapes surgery. These outcomes are comparable to those documented in traditional use of the microscope for stapedectomy. Laryngoscope, 130:1282-1286, 2020.
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Affiliation(s)
- Andrew C Hall
- Department of Otolaryngology, Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - Rishi Mandavia
- Department of Otolaryngology, Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - David Selvadurai
- Department of Otolaryngology, St. George's Hospital, London, United Kingdom
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Ayache S, Beltran M, Guevara N. Endoscopic classification of the external auditory canal for transcanal endoscopic ear surgery. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:247-250. [DOI: 10.1016/j.anorl.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pradhan P, Preetam C. Endoscopic stapedotomy: a comparison between 4 mm and 3 mm nasal endoscope. Eur Arch Otorhinolaryngol 2019; 276:3035-3041. [DOI: 10.1007/s00405-019-05592-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/01/2019] [Indexed: 01/15/2023]
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Rusetsky YY, Meitel IY, Sotnikova LS, Malyavina US, Kalugina MS. [Prospects of endoscopic otosurgery in children]. Vestn Otorinolaringol 2019; 84:5-11. [PMID: 31486419 DOI: 10.17116/otorino2019840315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Active progress in otosurgery opens up new opportunities for minimally invasive surgeries and significantly improves the results of treatment, but a number of problems remain unsolved, including in children. Despite the general positive trend of using the endoscope in otosurgery, in pediatric practice the data are insufficient and extremely contradictory. Literary sources show that, with certain advantages, the existing techniques of endoscopic tympanoplasty are far from perfect and inferior in effectiveness to classical microscopic techniques, which also necessitates further research in this field.
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Affiliation(s)
- Yu Yu Rusetsky
- National medical research center for children's health of the Ministry of health of Russia, Moscow, Russia, 119991
| | - I Yu Meitel
- National medical research center for children's health of the Ministry of health of Russia, Moscow, Russia, 119991
| | - L S Sotnikova
- National medical research center for children's health of the Ministry of health of Russia, Moscow, Russia, 119991
| | - U S Malyavina
- National medical research center for children's health of the Ministry of health of Russia, Moscow, Russia, 119991
| | - M S Kalugina
- National medical research center for children's health of the Ministry of health of Russia, Moscow, Russia, 119991
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A modified method of local infiltration for endoscopic stapes surgery: how I do it. Eur Arch Otorhinolaryngol 2018; 276:357-365. [PMID: 30535977 DOI: 10.1007/s00405-018-5238-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 12/03/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To present a modified method of local infiltration (MMLI) for endoscopic stapes surgery to reduce surgical time, bleeding and complications. MATERIALS AND METHODS This study involved 70 patients who underwent stapes surgery for otosclerosis by endoscopic and microscopic approaches. The MMLI was applied as follows: local infiltration was performed with one hand while the other hand inserted the endoscope into the ear canal to observe vasoconstriction signs on the monitor; the single site of infiltration was located at the center of the anterior conchal cartilage. Operative time, intraoperative blood loss, preservation of anatomical structures, postoperative hearing and complications were evaluated. RESULTS The MMLI allowed for quick bleeding control and a clear and dry operative field. Operative time, intraoperative blood loss and preservation of anatomical structures were significantly reduced in the endoscopic group (P < 0.00) versus the microscopic group. The scutum was removed less frequent in the endoscopic group 7.1% versus 53.6% of the microscopic group (P < 0.00). The chorda tympani was preserved in all cases but it was more manipulated in the microscopic group 39.3% versus 9.5% of the endoscopic group (P < 0.00). No complications were observed and the hearing outcomes were significantly better than the preoperative thresholds. CONCLUSIONS This is the first report on the use of a MMLI for endoscopic stapes surgery. Using this method, the surgeon performs the infiltration at one site and concurrently observes the vasoconstriction signs without the use of a microscope, frontal lamp or speculum. This method provides benefits in terms of operative time and complications.
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Novel three-dimensional image system for endoscopic ear surgery. Eur Arch Otorhinolaryngol 2018; 275:2933-2939. [DOI: 10.1007/s00405-018-5153-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/26/2018] [Indexed: 12/16/2022]
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Kuo CW, Wu HM. Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 2018; 138:871-876. [PMID: 30113877 DOI: 10.1080/00016489.2018.1490029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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.
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Affiliation(s)
- Chia-Wei Kuo
- Department of Otolaryngology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
| | - Hsing-Mei Wu
- Department of Otolaryngology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
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Moneir W, Abd El-fattah AM, Mahmoud E, Elshaer M. Endoscopic stapedotomy: Merits and demerits. J Otol 2018; 13:97-100. [PMID: 30559773 PMCID: PMC6291631 DOI: 10.1016/j.joto.2017.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 11/13/2017] [Accepted: 11/14/2017] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Surgical microscopes are still preferred to perform stapes surgery; but the use of the endoscopes would offer much benefits such as good panoramic view and easy accessibility to the oval window niche, the stapes and facial nerve. In this study, we aimed to analyze and compare the outcomes and complications of endoscopic versus microscopic stapes surgery. PATIENTS AND METHODS This work was done at the Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt, between September 2015 and July 2016. The patients; diagnosed as having otosclerosis and full filled the selection criteria; were randomly divided into 2 groups. RESULTS The group A (microscopic group) included 28 patients (aged 19-60 years) and the group B (endoscopic group) included 14 patients (aged 22-56 years). Mean follow-up durations were 4.5 months (1-8.5) in the endoscopic group and 5.5 months (1.5-8) in the microscopic group. The difference in preoperative and postoperative air-bone gap in two groups was statistically significant (p = 0.031). But there was no statistical difference for hearing results between two groups and the two techniques have similar audiological outcomes. The main merits of endoscopic stapedotomy are the good quality panoramic image, well identification and visualization of vital structures of the middle ear, minimal handling of chorda tympani nerve if needed with practically no curettage of bony wall. CONCLUSIONS The present series shows that it is possible to perform stapes surgery using only the 4mm in diameter and 18cm long endoscopes of different angulations, without major difficulties.
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Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience. The Journal of Laryngology & Otology 2018; 132:493-496. [DOI: 10.1017/s0022215118000695] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundTotally endoscopic ear surgery and endoscope-assisted microsurgery are still new concepts, with relatively few centres in the UK performing them. Advantages include better visualisation of difficult to reach areas, such as the sinus tympani, and limited external incisions. This paper reports our short-term outcomes for endoscopic middle-ear surgery.MethodsA prospective review was conducted of the first 103 consecutive patients undergoing totally endoscopic ear surgery or endoscope-assisted microsurgery in 1 centre performed by 1 operator. The outcomes assessed were: tympanic membrane healing, audiological data and complications.ResultsTwenty-five patients underwent endoscope-assisted microsurgery, while 78 had totally endoscopic ear surgery. There were no reported cases of dead ear or permanent facial nerve palsy. The average air–bone gap following stapedectomy was 7.38 dB. The tympanic membrane healing rate was 89 per cent.ConclusionOur results confirm that endoscopic middle-ear surgery is safe, and the short-term outcomes are comparable with conventional surgery.
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Rzaev RM, Rzaev RR, Rzaev RR. [The modern state and prospects of development of endoscopic otosurgery]. Vestn Otorinolaringol 2018; 83:74-78. [PMID: 30412182 DOI: 10.17116/otorino20188305174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this review presents data on efficiency endoscopic operations at some ear diseases. Now endoscopic operations are widely applied at primary and residual (or recuring) middle ear cholesteatomas, tympanic membrane perforation, otosclerosis and cochlear implantation. Proceeding from resolving power of endoscopic technology, endoscopic operation can be applied as an independent method, or as an endoscopic assisted, to be combined with otomicrosurgery operation. Efficiency of endoscopic operation in many respects is defined by a possibility of panoramic visualization of anatomical structures of middle and inner ear, and also carrying out high-quality elimination of focus lesion from areas, being remote when performing otomicrosurgery operation.
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Affiliation(s)
- R M Rzaev
- Department of Otorhinolaryngology - Head and Neck Surgery, Central Azerbaijan Railway Hospital, Baku, Azerbaijan
| | - R R Rzaev
- State Scientific Clinical of Otorhinolaryngology, Federal Medico-Biological Agency, Moscow, Russia
| | - Rd R Rzaev
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia
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Surmelioglu O, Ozdemir S, Tarkan O, Tuncer U, Dagkiran M, Cetik F. Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 2017; 44:253-257. [DOI: 10.1016/j.anl.2016.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/15/2023]
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Abstract
The objective of the present work was to study the specific endoscopic anatomical features of the middle ear using the dissected temporal bones with the intact tympanic membrane. The 18 cm long endoscopes 4 mm in diameter with a visual angle from 0 to 45 degrees in the combination with some other microinstruments, such as ear pincers, needles, curettes, elevators, and suction tubes, were used during the examination. It was shown that endomeato-transtympanic endosopy provides a panoramic view of almost all structures of the middle ear. After the resection of the posterior bone edge of 'annulus tympanicus', the use of the 45o endoscope ensured the panoramic view not only of certain structures of the middle ear (e.g. the tympanic chord, the stapedius muscle tendon, the entire pyramidal process) but also of the structures of the retrotympanic and anterior epitympanic spaces.
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Affiliation(s)
- R M Rzaev
- Department of Otorhinolaryngology - Head and Neck Surgery, Central Azerbaijan Railway Hospital, Baku, Azerbaijan, AZ1117
| | - R R Rzaev
- State Scientific Clinical Centre of Otorhinolaryngology, Federal Medico-Biological Agency, Moscow, Russia, 125310
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Hunter JB, Zuniga MG, Leite J, Killeen D, Wick C, Ramirez J, Rivas JA, Nogueira JF, Isaacson B, Rivas A. Surgical and Audiologic Outcomes in Endoscopic Stapes Surgery across 4 Institutions. Otolaryngol Head Neck Surg 2016; 154:1093-8. [DOI: 10.1177/0194599816633654] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/29/2016] [Indexed: 12/27/2022]
Abstract
Objectives To investigate intra- and postoperative outcomes of endoscopic stapes surgery. Study Design Case series with chart review. Setting Four tertiary care otologic centers. Subjects and Methods Sixty-five subjects 18 years and older who underwent endoscopic stapes surgeries were analyzed. Variables analyzed included surgical techniques and intraoperative findings. Outcomes measured included postoperative hearing and complications to date. Results Fifty-one patients met inclusion and exclusion criteria. The average patient age was 48.1 years (range, 26-87 years), with 60.0% female patients. Patients had a median follow-up of 5.13 months (range, 0.8-57.4 months). Of the subjects, 71.7% required scutum removal. The chorda tympani nerve was manipulated in 94.0% of subjects and transected in 12.0%. At last follow-up visit, the median air-bone gap decreased from 34.5 dB hearing level (HL) preoperatively to 9.0 dB HL postoperatively ( P < .0001). Ninety percent of subjects had closure of their air-bone gap ≤20 dB HL. Intraoperative complications included tympanic membrane tears in 8.0% of subjects, all of which resolved at first follow-up. Postoperatively, 10.0% of subjects complained of altered taste. Conclusions The present multicentered study of endoscopic stapes surgery demonstrates similar audiometric and postoperative outcomes previously published in the literature, with a median postoperative air-bone gap of 9.0 dB HL. Future prospective endoscopic stapes surgery studies, addressing the need for scutum removal, postoperative taste changes, and pain scores, are merited.
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Affiliation(s)
- Jacob B. Hunter
- The Otology Group, Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - M. Geraldine Zuniga
- The Otology Group, Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Daniel Killeen
- Department of Otolaryngology–Head and Neck Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Cameron Wick
- Department of Otolaryngology–Head and Neck Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | - Brandon Isaacson
- Department of Otolaryngology–Head and Neck Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Alejandro Rivas
- The Otology Group, Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Daneshi A, Jahandideh H. Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngol 2015; 273:631-4. [DOI: 10.1007/s00405-015-3614-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 03/24/2015] [Indexed: 12/30/2022]
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Kanona H, Virk JS, Owa A. Endoscopic ear surgery: A case series and first United Kingdom experience. World J Clin Cases 2015; 3:310-317. [PMID: 25789304 PMCID: PMC4360503 DOI: 10.12998/wjcc.v3.i3.310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/17/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To present the United Kingdom’s first case series of 70 otological cases of endoscopic and non-endoscopic ear surgeries.
METHODS: Prospective case series incorporating a range of endoscopic procedures performed using a 4 mm, 18 cm rigid endoscope, performed by a single surgeon at a single centre. Primary outcome measures included mean average pre and post-operative air-bone gap hearing thresholds and duration of surgery.
RESULTS: Thirty-eight patients underwent endoscopic assisted ear surgery and 32 underwent non-endoscopic assisted ear surgery. In both surgical groups, there was a significant difference between pre and post-operative mean air-bone gaps (P = 0.02). Mean operating time was comparable between both groups. Eight patients developed post-operative complications.
CONCLUSION: Endoscopic ear surgery can be performed safely in a range of otological procedures. This has the potential to become a well-established surgical option for middle ear surgery in the near future. Advantages and limitations are discussed.
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Endoscopic stapedotomy: our view point. Eur Arch Otorhinolaryngol 2014; 273:37-41. [DOI: 10.1007/s00405-014-3468-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/19/2014] [Indexed: 12/27/2022]
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Ovine ear model for fully endoscopic stapedectomy training. Eur Arch Otorhinolaryngol 2014; 272:2167-74. [DOI: 10.1007/s00405-014-3114-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 05/20/2014] [Indexed: 12/14/2022]
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A practical use of a 16-gauge peripheral angiocatheter as an aspiration cautery in endoscopic ear surgery. Otol Neurotol 2014; 35:1123-4. [PMID: 24786543 DOI: 10.1097/mao.0000000000000387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To define a technique for the practical use of a 16-gauge peripheral venous catheter as an insulated aspiration cautery in endoscopic ear surgery. STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. MATERIALS AND METHODS A 16-gauge intravenous catheter was prepared as a cauterization instrument with aspiration. After simple rearrangement of the exterior plastic portion, it was connected to a suction system. With the help of an unipolar cautery, aspiration of the blood and homeostasis was achieved. RESULTS Hemorrhage of the external ear canal skin after incision can be easily coagulated with this instrument. During follow-up, there were no wound infection, facial nerve paresis, scar formation, and inadvertent burn of the external canal and auricular skin. CONCLUSION With the help of this instrument, bleeding control during incision can be easily maintained. It is a simple, easily prepared, and alternative homeostasis technique in endoscopic ear surgery.
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