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Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
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Stapedotomy using a 4 mm endoscope: any advantage over a microscope?

A Bhardwaj1, A Anant1, N Bharadwaj1

  • 1Department of ENT,Head and Neck Surgery,Vardhaman Mahavir Medical College and Safdarjung Hospital,New Delhi,India.

The Journal of Laryngology and Otology
|September 11, 2018
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Summary

Endoscopic stapedotomy offers comparable hearing results to microscopic approaches. This minimally invasive technique avoids canalplasty and reduces chorda tympani manipulation, proving its feasibility.

Keywords:
EndoscopesMicroscopyOtosclerosisStapes Surgery

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Area of Science:

  • Otolaryngology
  • Minimally Invasive Surgery

Background:

  • Otosclerosis treatment traditionally involves microscopic stapedotomy.
  • The feasibility and comparative outcomes of endoscopic stapedotomy remain an area of interest.

Purpose of the Study:

  • To evaluate the feasibility of 4 mm endoscopic stapedotomy.
  • To compare intra- and post-operative outcomes between endoscopic and microscopic stapedotomies.

Main Methods:

  • A comparative study involving 40 otosclerosis patients undergoing either microscopic or endoscopic stapedotomy.
  • Intra-operative variables included incision type, canalplasty, ossicular assessment, chorda tympani manipulation, stapes footplate perforation, and operative time.
  • Post-operative outcomes assessed were ear pain and hearing improvement.

Main Results:

  • Endoscopic stapedotomy required fewer ancillary procedures like canalplasty and canal wall curettage compared to microscopic stapedotomy.
  • The endoscopic group showed less chorda tympani manipulation and a higher rate of successful stapes footplate perforation.
  • Both methods yielded comparable hearing improvements, with mean air-bone gaps of 10.73 dB (endoscopic) and 13.81 dB (microscopic) post-operatively.

Conclusions:

  • Endoscopic stapedotomy is a feasible alternative with comparable hearing outcomes to microscopic stapedotomy.
  • The sinonasal endoscope facilitates a minimally invasive approach, reducing the need for canalplasty and chorda tympani manipulation.
  • Endoscopic stapedotomy demonstrates advantages in surgical technique and patient recovery.