Fisch's Reversal Steps Stapedotomy

Malafronte, Giuseppe; Filosa, Barbara

doi:10.1097/mao.0b013e3181be686e

Cited by 23 publications

(18 citation statements)

References 5 publications

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“…7 This indicates that the incidence of complications associated with extensive bone curettage/ drilling, for example, a possible iatrogenic trauma to ossicular chain and extensive chorda manipulation or decompression, was minimal. [8][9][10] Extent of chorda tympani manipulation is another major issue in stapes surgery. In conventional microscopic stapedotomy, the chorda tympani is stretched inferiorly and further manipulation of the incudostapedial complex is carried out through the window that is created between the stretched chorda and the postero-superior canal wall.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

et al. 2019

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The study is aimed to assess the scope of endoscopic stapedotomy in overcoming technical challenges faced during conventional stapedotomy using operating microscope. Sixty-four patients with clinical and audiological diagnosis of otosclerosis were randomly assigned into one of the 2 groups—one underwent conventional stapedotomy using operating microscope, while the other group underwent endoscopic stapedotomy, the operating surgeon being the same for both groups, for all cases. The 2 groups were observed in terms of extent of the postero-superior canal bone curettage/drilling, chorda tympani repositioning, visualization of footplate area, surgical time from first incision to ear packing, post-operative morbidity in terms of post-operative pain, vertigo, hearing outcome, and changes in taste sensation. It was observed that irrespective of the width of the external auditory canal, endoscopic approach offered better access to the footplate area requiring lesser bone removal and chorda tympani repositioning. The operating time, post-operative pain, and changes in taste sensation were significantly less in the endoscopic group. However, no difference was noted in terms of the post-operative hearing outcome and incidence of vertigo. Endoscopic stapedotomy has clear advantages in terms of the technicality and accessibility to the working area as well as faster recovery.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

et al. 2019

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“…According to his method, dislocation of the incus, luxation, and fracture of the footplate are avoided by performing the footplate hole and fixing the prosthesis to the incus before removing the stapes superstructure [21][22][23] .…”

Section: Surgical Proceduresmentioning

confidence: 99%

Endoscopic vs Microscopic Approach in Stapes Surgery: Advantages in the Middle Ear Structures Visualization and Trainee's Point of View

Iannella

Marcotullio²,

Re³

et al. 2017

Int Adv Otol

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OBJECTIVE:Comparing the endoscopic and microscopic approaches in stapes surgery, and establishing the surgical approach that allows better results in terms of visualization of the middle ear structures and aids assistant's training. MATERIALS and METHODS:Twenty-one residents from the first to the fifth year of training in Otolaryngology were enrolled in this prospective study. A questionnaire specifically designed to investigate the understanding of middle ear anatomy, the surgical steps, and a personal opinion about endoscopic stapes surgery was submitted to each resident. RESULTS:Statistical differences between the endoscopic and microscopic approaches were evident about identification of stapes and long process of the incus (p=0.03) and stapes footplate and the oval window (p=0.03). No substantial difference between the two surgical approaches emerged regarding the visualization of the tympanic membrane and the other middle ear structures (p>0.5). A substantial difference in favor of the endoscopic approach emerged regarding the identification of the hole creation in the footplate of the stapes. CONCLUSION:Endoscopic stapes surgery could favor an easier understanding of the surgical technique for assistants in training with little knowledge of the anatomy and surgical steps.

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“…The stapes and oval window niche (OWN) can be obscured by the scutum. Excessive removal of the bone for better visualization of the middle ear (ME) structures can rarely result in subluxation of the incus [49][50][51]. When the posterior part of the bony annulus is removed to visualize the stapes, the chorda tympani nerve (CTN) can be occasionally touched, stretched, manipulated or transected and result in 20-60% of postoperative taste disorders or tongue symptoms [52][53][54][55][56][57].…”

Section: Endoscopic Stapedotomymentioning

confidence: 99%

Minimally Invasive Transcanal Endoscopic Ear Surgery

Migirov¹,

Wolf²

2015

Endoscopy - Innovative Uses and Emerging Technologies

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Endoscopes have rapidly become widely accepted in the performance of ear surgery. Current chapter describes surgical technique and benefits and limitations for endoscopic eradication of cholesteatoma, endoscopic tympanoplasty, endoscopic stapedotomy and endoscopic cochlear implantation.Minimally invasive endoscopic and endoscope-assisted surgical techniques are increasingly being employed in the surgical management of cholesteatoma. Endoscopic surgeries distinctly reduced residual cholesteatomas and the indications of later tympanotomy thanks to the good visualization of residual cholesteatoma sites, such as the anterior and posterior epitympanic spaces, sinus tympani, facial recess, and hypotympanum. Minimally invasive transcanal endoscopic approach can be applied as for primary cholesteatomas as well as for revision of CWU cases, when residual/recurrent cholesteatoma is confined to the middle ear, and in CWD or radical cavities, when residual/recurrent disease is hidden in the supratubal recess, sinus tympani or under pseudo-membrane in the large mastoid cavities.The use of endoscopes in myringoplasty is especially helpful in patients with narrow external canals, anterior defects and bone overhang, when perforation's margins are barely, if at all, visible under a microscope.The transcanal endoscopic stapedotomy can be beneficial in improving the visibility and accessibility of the stapes and the oval window niche, avoiding manipulation of the chorda tympani nerve and blind fracture of the stapedial crurae.An endoscopic cochlear implantation involves entering the middle ear by means of endoscopic transcanal tympanotomy and insertion of the electrode array into the scala tympani via the round window under direct endoscopic control. The main benefits of the endoscopic transcanal approach to cochlear implant are improving the visibility and accessibility of the round window membrane, obviating the need to divide the chorda tympani nerve in order to obtain adequate exposure of the middle ear structures, and eliminating the risk of the facial nerve injury since it is not in the direction of drilling.

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Fisch's Reversal Steps Stapedotomy

Cited by 23 publications

References 5 publications

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

Endoscopic vs Microscopic Approach in Stapes Surgery: Advantages in the Middle Ear Structures Visualization and Trainee's Point of View

Minimally Invasive Transcanal Endoscopic Ear Surgery

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