Functional Results and Learning Curve of Endoscopic Stapes Surgery: A 10‐Year Experience

Abstract

Objectives/Hypothesis: To assess hearing outcomes and complications of endoscopic stapes surgery by a single surgeon in a 10-year period, to compare these data with conventional microscopic procedures by the same operator, and to describe the learning curve of endoscopic stapedotomy. Study Design: Retrospective study. Methods: This is a retrospective study on patients who underwent endoscopic stapes surgery performed by the same senior surgeon, experienced both in microscopic and endoscopic techniques, between January 2009 and December 2018. Audiological data were compared, and intraoperative and postoperative complications were collected. The surgeon's last 30 cases of microscopic stapedotomy were enrolled as the control group. The results of the first 100 endoscopic stapes surgeries were analyzed separately to create a cumulative sum (CUSUM) control chart for learning curve assessment. Results: One hundred seventy-eight endoscopic and 30 microscopic stapes surgeries were included. In the endoscopic group, the mean postoperative air-bone gap was 8.2 dB. No significant differences between the endoscopic and microscopic preoperative and postoperative values were reported. A total of eight complications (4.5%) were observed in the endoscopic cohort, although in the control group, no complication occurred. The mean surgical time was 51.9 minutes in the endoscopic group versus 48.2 minutes in the microscopic group (P > .05). No association between stapedotomy success and the increasing number of procedures was found. Conclusions: Our article demonstrates that functional results from endoscopic stapes surgery are similar to those from microscopic stapes surgery in terms of both safety and efficacy. After gaining endoscopic experience, the surgical duration of stapes surgery will be adequate starting from the first cases.

“Hot” vs “Cold” endoscopic stapes surgery: a matched case–control study

“…Although traditionally SS has been performed using the microscope, lately the technological advancements have allowed the use of the endoscope as an alternative approach. A consistent number of papers showed comparable operative times, complication rates, and audiological outcomes between the two approaches [1][2][3].…”

Recurrence of conductive hearing loss after stapes surgery: a narrative review

“…The use of the endoscope in stapes surgery has shown excellent results that are comparable to those with the microscopic technique, according to several reports 20 , 23 .…”

“…Primary stapes surgery can be considered successful if an ABG of < 10 dB is achieved 22 , 23 . Similarly, the success of revision surgery is generally confirmed by closure of the post-operative ABG within 10 dB.…”

Endoskopische Ohrchirurgie in Deutschland

“…Nur selten wurde eine Stapesplastik als Indikation angesehen. Wie in einem Vergleich zwischen endoskopischer und mikroskopischer Technik an knapp 200 Fällen gezeigt wurde, weisen insbesondere die Hörergebnisse sowie die Schnitt-Naht-Zeiten keine signifikanten Differenzen auf [ 14 ], weshalb das endoskopische Vorgehen hier außer einem etwas geringeren Aufwand auch keinen wesentlichen Vorteil gegenüber der MES erkennen lässt.…”