Comparison of Endoscopic and Microscopic Reversal Stapedotomies: Our Clinical Experience in 87 Patients with Otosclerosis

Dalğıç, Abdullah; Aysel, Abdulhalim; Aydın, Enes; Aksoy, Gökçe; Olgun, Levent

doi:10.5152/b-ent.2023.21633

Cited by 2 publications

(3 citation statements)

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“…Postoperative pain scores were reported to be lower in the endoscopic group. 8,10,[16][17][18] Our investigation revealed that the pain scores in the endoscopic group were lower compared to those in the microscopic group, which is in accordance with previous studies. Higher pain scores in the microscopic group may be due to the endaural incision used in some studies, 8 but we used a trans-canal incision in this study for all patients.…”

Section: Discussionsupporting

confidence: 92%

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Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial

Emami,

Amirzargar,

Nemati

et al. 2023

The Laryngoscope

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ObjectiveTo determine the outcomes and complications of endoscopic versus microscopic stapes surgery in patients with otosclerosis.Study DesignRandomized, single‐blinded clinical trial.MethodsPatients with otosclerosis who underwent either trans‐canal microscopic or endoscopic stapedotomy at a tertiary care hospital were compared. Thirty‐two patients were randomly divided into two groups using blocked randomization. Group A consisted of 16 patients who underwent trans‐canal microscopic stapedotomy, and group B consisted of 16 patients who underwent trans‐canal endoscopic stapedotomy. Postoperative vertigo, ear pain, and complications such as tympanic membrane perforation or chorda tympani nerve injury were evaluated. Three months postoperatively, patients were assessed for dysgeusia and hearing improvement.ResultsThe mean pre‐operative air‐bone gap (ABG) in the microscopic and endoscopic groups was 32.81 ± 6.82 and 30.00 ± 7.96, respectively. The mean improvement in the ABG was 25.45 ± 11.21 dB in the microscopic group and 23.21 ± 10.68 dB in the endoscopic group. Although both techniques showed improvement in auditory outcomes (p‐value <0.001), there were no statistical differences between the endoscopic and microscopic groups in the pre‐operative, post‐operative, and mean improvement of ABG (p‐value >0.05). There were no significant differences between the two methods in chorda tympanic nerve injury, vertigo scores, and the mean operating time (p‐value >0.05), but the mean pain score was higher in the microscopic group (2.56 ± 1.55 in the microscopic group versus 1.31 ± 0.70 in the endoscopic group) (p‐value = 0.003).ConclusionsEndoscopic stapes surgery can be a preferable alternative to conventional microscopic stapedotomy, as it yields similar hearing outcomes and lower pain scores.Level of Evidence2 Laryngoscope, 2023

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Section: Discussionsupporting

confidence: 92%

“…While several studies showed no statistically significant difference regarding post-surgery dizziness, 8,13,14,16 others showed a lower incidence of dizziness in endoscopic groups relative to microscopic groups. 10,17 No significant difference was found in our analysis regarding the mean vertigo score between the two groups.…”

Section: Discussionmentioning

confidence: 57%

Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial

Emami,

Amirzargar,

Nemati

et al. 2023

The Laryngoscope

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“…18,[28][29][30][31] Özdek et al 32 described using fiberoptic CO 2 laser in fully endoscopic stapes surgery to make a fenestra with favorable results. Güneri and Olgun 33 reported their endoscopic stapedotomy outcomes in 32 ears of 31 patients using a handheld CO 2 laser to create a fenestra, wherein they found less scutum removal, postoperative vertigo, and chorda tympani manipulation with comparable hearing results to the microscopic group. Although some studies reported better hearing outcomes of the CO 2 laser than other laser types, 23,34 the drawback of CO 2 laser fiber is the high surgical supply cost (852.60 ± 285.53 US$).…”

Section: Intra-postoperative Complicationsmentioning

confidence: 99%

The utility and safety of diode laser in endoscopic stapes surgery

Plodpai

2023

Laryngoscope Investig Oto

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Objective The advantages of laser stapedotomy are less trauma and more precise and minimally invasive techniques; however, the potential risk of overheating from the laser combined with the endoscope tip must be considered. This study aimed to assess the efficacy and safety of diode lasers for endoscopic stapes surgery. Methods A retrospective review of 56 patients with otosclerosis who underwent primary endoscopic stapedotomy with a diode laser from 2017 to 2020 was conducted. Demographic data, intraoperative findings, preoperative and postoperative audiological assessments, and postoperative complications were analyzed. Results There was no statistically significant difference between the preoperative and postoperative bone conduction thresholds. The mean postoperative air‐bone gap (ABG) improved significantly compared to the preoperative ABG (4.07 vs. 35.43 dB, p < .001). The postoperative ABG closure within 10 dB at 6 and 12 months was achieved in 87.50% and 91.07% of patients, respectively. The postoperative pain scores at 4 and 24 h were 2.55 and 0.39, respectively. Immediate postoperative vertigo was reported in 12.50% of patients, with 100% complete recovery 2 months after surgery. The chorda tympani nerve was preserved in all the cases. Postoperative taste disturbances at 2 and 12 months were observed in 17.86% and 1.79% of patients, respectively. Conclusion The diode laser in endoscopic stapedotomy is a safe and effective technique that provides satisfactory hearing outcomes. Temporary taste disturbances during the early postoperative period are a concern. The handheld diode laser delivery system is suitable for an endoscopic approach and is an alternative armamentarium for the treatment of otosclerosis. Level of evidence: IV.

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Comparison of Endoscopic and Microscopic Reversal Stapedotomies: Our Clinical Experience in 87 Patients with Otosclerosis

Cited by 2 publications

References 0 publications

Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial

Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial

The utility and safety of diode laser in endoscopic stapes surgery

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