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Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial.

Hamed Emami1, Behrooz Amirzargar1, Yasaman Nemati1

  • 1Otorhinolaryngology Research Center, Department of Otorhinolaryngology-Head and Neck Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

The Laryngoscope
|December 19, 2023
PubMed
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Endoscopic stapes surgery offers similar hearing improvements to microscopic stapedotomy for otosclerosis patients. This endoscopic approach resulted in significantly lower postoperative pain scores.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Auditory Health

Background:

  • Otosclerosis is a condition affecting the stapes bone, leading to hearing loss.
  • Microscopic stapedotomy is a traditional surgical technique for otosclerosis.
  • Endoscopic techniques are emerging as alternatives in otologic surgery.

Purpose of the Study:

  • To compare the outcomes and complications of endoscopic versus microscopic stapes surgery.
  • To evaluate hearing improvement and postoperative adverse events in otosclerosis patients.

Main Methods:

  • A randomized, single-blinded clinical trial involving 32 otosclerosis patients.
  • Patients underwent either trans-canal microscopic stapedotomy (16 patients) or trans-canal endoscopic stapedotomy (16 patients).
Keywords:
endoscopemicroscopeotosclerosisstapedotomystapes surgery

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  • Outcomes assessed included postoperative vertigo, ear pain, complications, dysgeusia, and hearing improvement (air-bone gap).

    • Main Results:

    • Both endoscopic and microscopic stapedotomy demonstrated significant improvements in auditory outcomes (p<0.001).
    • No statistical differences were found between the groups in hearing improvement (air-bone gap), operative time, or nerve injury (p>0.05).
    • The endoscopic group reported significantly lower mean pain scores post-surgery (p=0.003).

    Conclusions:

    • Endoscopic stapes surgery is a viable alternative to microscopic stapedotomy for otosclerosis.
    • It provides comparable hearing outcomes with the added benefit of reduced postoperative pain.
    • Endoscopic stapedotomy may be a preferable option for patients undergoing stapes surgery.