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Stapedotomy using a 4 mm endoscope: any advantage over a microscope?

Published online by Cambridge University Press:  10 September 2018

A Bhardwaj ,
A Anant ,
N Bharadwaj ,
A Gupta  and
S Gupta
A Bhardwaj*
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
A Anant
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
N Bharadwaj
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
A Gupta
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
S Gupta
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
*
Author for correspondence: Dr Abhishek Bhardwaj, Dept. of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India E-mail: abhi04stanley@gmail.com Fax: +91 11 2616 3072
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Abstract

Objectives

To ascertain the feasibility of endoscopic (4 mm) stapedotomy, and compare intra- and post-operative variations with microscopic stapedotomies.

Methods

Forty otosclerosis patients were scheduled for microscopic or endoscopic stapedotomy. Intra-operative variables compared were: incision, canalplasty, canal wall curettage for ossicular assessment, chorda tympani manipulation, ability to perform stapes footplate perforation before its supra-structure removal, and operative time. Post-operative variables compared were ear pain and hearing improvement.

Results

Of the 20 microscopy patients, 4 required endaural incision and canalplasty because of canal overhangs, and 7 required canal wall curettage for ossicular assessment. None of the 20 endoscopy patients required these procedures. Chorda tympani was manipulated in 13 and 6 patients in the microscopy and endoscopy groups respectively, while the stapes footplate could be perforated in 5 and 11 patients respectively. Mean operative time was 50.25 and 76.05 minutes in the microscopy and endoscopy groups respectively. In the endoscopy group, mean air–bone gap was 37.12 and 10.73 dB pre- and post-operation respectively; in the microscopy group, these values were 35.95 and 13.81 dB.

Conclusion

Endoscopic stapedotomy has comparable hearing outcomes. Sinonasal endoscope serves as a better tool for: minimal incision, canalplasty avoidance, less chorda tympani mobilisation, and stapes footplate perforation ability.

Keywords

EndoscopesOtosclerosisStapes SurgeryMicroscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 807 - 811
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr A Bhardwaj takes responsibility for the integrity of the content of the paper

References

1Poe, DS. Laser-assisted endoscopic stapedectomy: a prospective study. Laryngoscope 2000;110:1–37Google Scholar
2Nogueira Júnior, JF, Martins, MJ, Aguiar, CV, Pinheiro, AI. Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 2011;77:721–7Google Scholar
3Sarkar, S, Banerjee, S, Chakravarty, S, Singh, R, Sikder, B, Bera, SP. Endoscopic stapes surgery: our experience in thirty two patients. Clin Otolaryngol 2013;38:157–60Google Scholar
4Yadav, SP, Aggarwal, N, Julaha, M, Goel, A. Endoscope-assisted myringoplasty. Singapore Med J 2009;50:510–12Google Scholar
5Tarabichi, M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol 1999;108:39–46Google Scholar
6Karhuketo, TS, Puhakka, HJ. Endoscope-guided round window fistula repair. Otol Neurotol 2001;22:869–73Google Scholar
7Lade, H, Choudhary, SR, Vashishth, A. Endoscopic vs microscopic myringoplasty: a different perspective. Eur Arch Otorhinolaryngol 2014;271:1897–902Google Scholar
8Migirov, L, Shapira, Y, Hoeowitz, Z, Wolf, M. Exclusive endoscopic ear surgery for acquired cholesteatoma. Otol Neurotol 2011;32:433–6Google Scholar
9Marchioni, D, Alicandri-Ciufelli, M, Molteni, G, Genovese, E, Presutti, L. Endoscopic tympanoplasty in patients with attic retraction pockets. Laryngoscope 2010;120:1847–55Google Scholar
10Yung, MM. The use of rigid endoscopes in cholesteatoma surgery. J Laryngol Otol 1994;108:307–9Google Scholar
11Marchioni, D, Alicandri-Ciufelli, M, Molteni, G, Villari, D, Monzani, D, Presutti, L. Ossicular chain preservation after exclusive endoscopic transcanal tympanoplasty: preliminary experience. Otol Neurotol 2011;32:626–31Google Scholar
12Marchioni, D, Villari, D, Alicandri-Ciufelli, M, Piccinini, A, Presutti, L. Endoscopic open technique in patients with middle ear cholesteatoma. Eur Arch Otorhinolaryngol 2011;268:1557–63Google Scholar
13Marchioni, D, Alicandri-Ciufelli, M, Piccinini, A, Genovese, E, Monzani, D, Tarabichi, M et al. Surgical anatomy of the transcanal endoscopic approach to the tympanic facial nerve. Laryngoscope 2011;121:1563–71Google Scholar
14Iannella, G, Magliulo, G. Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 2016;37:1350–7Google Scholar
15Sproat, R, Yiannakis, C, Iyer, A. Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol 2017;38:662–6Google Scholar
16Michael, P, Raut, V. Chorda tympani injury: operative findings and postoperative symptoms. Otolaryngol Head Neck Surg 2007;136:978–81Google Scholar
17Tarabichi, M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg 2010;62:6–24Google Scholar