Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

Das, Arindam; Mitra, Sandipta; Ghosh, Debaki; Sengupta, Arjun

doi:10.1177/0145561319862216

Cited by 20 publications

(50 citation statements)

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“…At the first follow-up in this study, 5 patients (16.66%) reported various degrees of taste dysfunction, and at 24 weeks, the number decreased to 2 (6.66%). Preservation of taste sensation in our study was significantly better than that reported in the literature, where 65.62% of patients had various degrees of taste dysfunction postoperatively ( Das et al., 2019 ). This encouraging result may be partially related to the transient nature of the taste disorder, which usually recovers within six months of surgery ( Yung et al., 2008 ; Guder et al., 2012 ; Berling Holm et al., 2017 ), as demonstrated in the present study.…”

Section: Discussioncontrasting

confidence: 76%

“…In the present study, the chorda tympani nerve was transposed in 11 patients (36.66%) and resected in 1 patient (3.33%) because of overstretching during surgery. As described by Das et al., 81.25% of the patients who underwent endoscopic stapes surgery required transposition of the chorda tympani nerve ( Das et al., 2019 ). The better preservation of the nerve in the present study may be due to the wide-angle view of the endoscope, requiring minimal displacement of the chorda tympani nerve.…”

Section: Discussionmentioning

confidence: 99%

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Primary endoscopic stapedotomy using 3 mm nasal endoscope: Audiologic and clinical outcomes

2020

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Objective To report the use of a 3 mm rigid nasal endoscope in primary endoscopic stapedotomy and clinical and audiological outcomes. Materials and methods Thirty patients diagnosed with primary otosclerosis underwent endoscopic stapedotomy that was performed using a 3 mm nasal endoscope (Karl Storz). At 6 months follow-up, the patients were evaluated for intraoperative findings, postoperative hearing outcomes and complications. Results Canaloplasty was performed in 2 (6.66%) patients, and no curettage of the canal wall was required in 12 (40%) patients. Transposition of the chorda tympani nerve was conducted in 11 (36.66%) patients. The average duration of surgery was 36 min (range 31–65 min). The air-bone gap (ABG) was 35 dB (range 24–50 dB) preoperatively and 14.63 dB (range 9–20 dB) postoperatively (p = 0.00). At 6 months follow-up, <20 dB ABG was achieved in 93.33% of the patients. No major intraoperative/postoperative complications were detected. Conclusion A 3 mm rigid nasal endoscope can be effectively used in stapedotomy to obtain adequate audiological outcomes. It can be considered as a better alternative to the standard microscope or 4 mm endoscope in preserving the posterior canal wall and chorda tympani nerve while minimizing operative time without causing significant complications.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Primary endoscopic stapedotomy using 3 mm nasal endoscope: Audiologic and clinical outcomes

2020

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“…The domain of transcanal endoscopic ear surgery has been expanding ever since, with surgeries addressing diseases involving external ear to as far as the lateral skull base. [1][2][3] The main reasons behind this are the technical advantages that endoscopes offer in comparison to conventional microscopes, such as a wider field of vision, higher magnification to see finer structural details and the ability to look around corners without disrupting normal tissues for the sake of access. 4 Although endoscopes have established a firm ground in otological surgery, there are legitimate concerns regarding their safety.…”

Section: Introductionmentioning

confidence: 99%

Prolonged intra-operative thermal exposure in endoscopic ear surgery: is it really safe?

et al. 2020

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Objective The aim of this study was to assess change in temperature, audiometric outcomes and post-operative complications following exposure to different light sources during endoscopic ear surgery. Method A total of 64 patients diagnosed with chronic otitis media with central perforation and pure conductive hearing loss underwent endoscopic type 1 tympanoplasty. The patients were randomised into two groups based on the light source used: xenon or light-emitting diode. Temperature was measured using a K type thermocouple at the promontory and round window niche. Mean temperature change with respect to operating time, mean audiometric change, incidence of vomiting in the first 24 hours, vertigo and tinnitus at the end of the first week were observed. Results Mean temperature change showed a statistically significant difference with increasing length of operating time with the xenon light source and when the two light sources were compared for a particular time interval. Mean audiometric change showed statistically significant deterioration at higher frequencies (4, 6 and 8 kHz) with the xenon light source but only at 8 kHz for the light emitting diode source. When the mean audiometric change was compared between light sources for a particular frequency, statistical significance was found at 4, 6 and 8 kHz. Post-operative complications were vomiting, vertigo and tinnitus (p-values of 0.042, 0.099 and 0.147, respectively, between two groups). Conclusion Light emitting diodes are associated with less significant middle-ear temperature rises and audiometric changes at higher frequencies when compared to xenon light sources. Hence, xenon should be replaced with cooler light sources.

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“…6 Stapedotomy is a safe effective procedure with 95% hearing restoration results reported. 2,4,7 Traditionally stapes surgery has been done using a microscope. Endoscopes were introduced in middle ear surgery in 1990's by Dr Muaaz Tarabichi, reported that endoscopic stapes surgery in 12 cases with 87% patients reporting audiological improvement.…”

Section: Discussionmentioning

confidence: 99%

“…3 Endoscopes have evolved as a tool of safe and effective surgery in otological practice and surpass the microscope in middle ear procedures owing to better visualization of anatomy in the middle ear. 4 Stapes surgery is no different and is increasingly being performed with endoscopes. We share our experience if 45 cases of total endoscopic stapes surgery.…”

Section: Introductionmentioning

confidence: 99%

Total Endoscopic Stapes Surgery. Our Technique and Experience of 45 Cases

Najam

Sarwar

Raza

et al. 2021

PAFMJ

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Objective: To assess the hearing results of transcanal endoscopic stapedotomy Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez Islamabad Pakistan, from Jun 2016 to Jun 2020. Methodology: All patients with surgically confirmed otosclerosis were included in the study. All patients were operated with 0-degree 3mm, 14cm rigid endoscope under general anesthesia. Preoperative and post operative air bone gap was noted along with demographic data, middle ear anomalies (persistent stapedial artery, dehiscent facial nerve, anteriorly placed facial nerve, floating foot plate) and injury to chorda tympani. Postoperative air bone gap (A-B Gap) was documented 12 weeks after surgery. All patients were followed up for 6-12 months Results: Mean age of patients was, 37 years and standard deviation was 12.34 (range 27-52 years). Out of total 45 cases 13 were males (29%) and 32 females (71.%). Four (8.8%) patients had dehiscent facial canal and 1 (2.2%) patient had persistent stapedial artery. Average preoperative A-B gap was 35 db and Average Postoperative A-B Gap was 7 db. Chorda tympani was preserved in all cases. One patient (2.2%) complained of altered taste which resolved after 3 months. Four patients had Postoperative vertigo that lasted 2 days on average. Conclusion: Endoscopic trans canal Stapes surgery is scarless safe effective procedure demonstrable hearing benefits in all patients with minimum complications. The Technique is single handed and has steep learning curve.

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Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

Cited by 20 publications

References 20 publications

Primary endoscopic stapedotomy using 3 mm nasal endoscope: Audiologic and clinical outcomes

Primary endoscopic stapedotomy using 3 mm nasal endoscope: Audiologic and clinical outcomes

Prolonged intra-operative thermal exposure in endoscopic ear surgery: is it really safe?

Total Endoscopic Stapes Surgery. Our Technique and Experience of 45 Cases

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