Different approach for surgery of stapes: Comparison microscopic and endoscopic approach

This study aimed to discuss the different surgical approach, functional hearing results, which are applied to patients operated with a diagnosis of otosclerosis in our clinic.

This study includes 92 ears of 84 patients who were operated with the diagnosis of otosclerosis. Air bone gap was calculated before and after the operation in all patients. In addition, endoscopic and microscopic methods can be compared and statistically tested whether there is a difference in air bone gap averages and surgical success. Of the 92 ears operated, 56 were right (61%) and 36 were left (39%). Otosclerosis was detected bilaterally in 61 patients (73%) and unilaterally (27%) in 23 patients. The duration of follow-up ranges from 6 month to ten years, on average 28 months.

In the microscopic operation group, the air pathway measurement was mean 55.58 dB preoperatively and mean 38.42 dB postoperatively, with a mean decrease of 17.16 dB determined. The decrease between the preoperative and postoperative air pathway values was determined to be statistically significant (t:7.20, p < 0.001). In the microscopic operation group, the air-bone gap value was mean 30.50 dB preoperatively and fell by 15.90 dB to 14.60 dB postoperatively. In the endoscopic group, the air-bone gap value was mean 32.32 dB preoperatively and fell by 13.51 dB to 18.81 dB postoperatively.

Stapes surgery is a successful method with high success rate and low complication rates in the treatment of otosclerosis. The success rate of endoscopic and microscopic stapes surgery is similar. However, endoscopic stapes surgery is specific and difficult otological surgery that must be performed by surgeons specialised on this subject.