Premium
Comparison between endoscopic and microscopic stapes surgery
Author(s) -
Kojima Hiromi,
Komori Manabu,
Chikazawa Satoshi,
Yaguchi Yuichiro,
Yamamoto Kazuhisa,
Chujo Kyoko,
Moriyama Hiroshi
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24144
Subject(s) - medicine , otosclerosis , surgery , endoscopy , endoscope , stapes , operating microscope , endoscopic surgery , middle ear
Objectives/Hypothesis To investigate whether endoscopic stapes surgery is safer and less invasive than conventional stapes surgery using an operating microscope. Study Design Retrospective study. Methods The subjects were 15 patients (15 ears) who underwent endoscopic stapes surgery for otosclerosis or congenital stapedial fixation. Another 35 patients (41 ears) in whom microscopic stapes surgery was performed by the same surgeon were assigned to the control group. The procedures for endoscopic surgery were fundamentally the same as those for microscopic surgery, unless there was no anterior or posterior auricular skin incision. The two surgical techniques were compared with respect to the operating time, postoperative hearing, complications, postoperative pain, and the extent of drilling at the posterosuperior part of the external auditory canal. Results There were no differences of operating time or postoperative hearing between the endoscopic and microscopic groups. There was very little postoperative pain in the endoscopic group. Postoperative dizziness was mild in all patients who received endoscopic surgery. Drilling at the posterosuperior part of the external auditory canal was less extensive in the endoscopic group than in the microscopic group. Conclusion Endoscopic surgery is particularly suitable for stapedial disease. Endoscopic stapes surgery can even be done in patients with a curved and narrow external auditory canal. Endoscopic surgery is also suitable for education: The surgical anatomy can be understood easily and both the surgeon and assistants can observe the procedure on the same monitor. However, it should only be performed by experienced surgeons because one‐handed manipulation is required and stereoscopic vision is not available. Level of Evidence 3b. Laryngoscope , 124:266–271, 2014