Microscopic versus endoscopic stapes surgery: systematic review and meta-analysis

Abstract

Objective To compare the efficacy and safety characteristics of endoscopic and microscopic stapes surgery based on current evidence. Methods A systematic literature search was conducted of three medical databases, focusing on randomised, controlled studies or observational studies. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarised using the pooled mean differences or pooled odds ratios, along with their 95 per cent confidence intervals. Results Thirteen studies were included in the meta-analysis. Success rate was evaluated by estimating air–bone gap improvement; this revealed comparable outcomes for the two techniques (mean difference = −0.20; 95 per cent confidence interval = −0.53, 0.14). No statistically significant difference was detected concerning post-operative complications, except for dysgeusia (odds ratio = −1.12; 95 per cent confidence interval = −1.97, −0.28) and pain (odds ratio = −2.00; 95 per cent confidence interval = −2.97, −1.04), which favoured the endoscopic approach. Conclusion Though both techniques result in commensurate outcomes concerning success rate, post-operative pain and dysgeusia favour the endoscopic approach. Further high-quality studies are needed to adequately compare the two methods.

Audiologic Outcomes After Vestibulotomy in Patients With Congenital Absence of the Oval Window

“…Nonetheless, if success in hearing outcome or subjective satisfaction is not achieved, appropriate counseling and information about the potential benefits of hearing aids and other auditory rehabilitation should be provided. Endoscopic middle ear surgery has recently shown comparable efficacy and safety to microscopic surgery (29,30). Endoscope can provide several advantages, including greater magnification, high-resolution visualization, and less invasiveness.…”

Comparison of different oval window sealing materials in stapes surgery: systematic review and meta-analysis

“…A certain homogeneity was found regarding the surgical approach used across the studies, the only exception being Pradhan et al [ 24 ] who utilized the endoscopic approach instead of the microscopic one. A recent meta-analysis [ 41 ] found the two approaches to be comparable, with less post-operative pain and dysgeusia for endoscopy. At the moment no articles on the influence that the surgical approach could have on the sealing procedure have been produced.…”

The utility and safety of diode laser in endoscopic stapes surgery

“… 1 Moreover, endoscopic stapes surgery is a less invasive technique while obtaining audiological and functional outcomes compared to a microscopic approach. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 …”

“…1 Moreover, endoscopic stapes surgery is a less invasive technique while obtaining audiological and functional outcomes compared to a microscopic approach. [2][3][4][5][6][7][8][9][10][11][12] Few studies have focused on the footplate fenestration technique in endoscopic stapedotomy. Fenestration of the stapes footplate is the most critical step with the potential risk of inner ear injury.…”

“…The endoscope‐assisted approach has been gaining acceptance as an alternative to stapes surgery because it provides excellent visualization and a magnified view of the middle ear cavity 1 . Moreover, endoscopic stapes surgery is a less invasive technique while obtaining audiological and functional outcomes compared to a microscopic approach 2–12 …”