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Erschienen in: European Archives of Oto-Rhino-Laryngology 4/2020

12.02.2020 | Otology

Tympanomeatal flap creation in endoscopic stapedotomy: cautery vs. cold instrumentation

verfasst von: Emine Demir, Metin Çeliker, Gökçe Aydın Balaban, Engin Dursun

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2020

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Abstract

Purpose

Bleeding is one of the most challenging issues for surgeons performing endoscopic stapedotomy. During creation and elevation of the tympanomeatal flap (TMF) prevention or control of bleeding greatly facilitates the safety and comfort in the next steps of the surgery. The aim of this study was to compare the effects of cautery versus cold instrumentation during creation of TMF at endoscopic stapedotomy surgery.

Methods

We investigated 15 patients TMF created with cautery and 14 patients with cold instrument, and compared bleeding scores, operation time, postoperative hearing, pain and complications between groups.

Results

The mean bleeding score was significantly lower in cautery incised patients compared to cold instrument patients (1.2 ± 0.9 vs. 2.3 ± 1, p = 0.005). Mean duration of surgery was also significantly shorter in cautery used patients (35.3 ± 6.8 vs. 48.8 ± 9.2 min, p < 0.001). There was no significant difference between postoperative pain, complications, wound healing, and auditory outcomes.

Conclusions

Cautery may be a better choice for the creation of TMF in endoscopic stapedotomy surgery due to reduced bleeding, shorter operation time and increased comfort without causing any complications.
Literatur
1.
Zurück zum Zitat Kuo CW, Wu HM (2018) Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 138:871–876CrossRef Kuo CW, Wu HM (2018) Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 138:871–876CrossRef
2.
Zurück zum Zitat Poe DS (2000) Laser-assisted endoscopic stapedectomy: a prospective study. Laryngoscope 110:1–37CrossRef Poe DS (2000) Laser-assisted endoscopic stapedectomy: a prospective study. Laryngoscope 110:1–37CrossRef
3.
Zurück zum Zitat Nogueira Junior JF, Martins MJ, Aguiar CV et al (2011) Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 77:721–727CrossRef Nogueira Junior JF, Martins MJ, Aguiar CV et al (2011) Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 77:721–727CrossRef
4.
Zurück zum Zitat Surmelioglu O, Ozdemir S, Tarkan O et al (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44:253–257CrossRef Surmelioglu O, Ozdemir S, Tarkan O et al (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44:253–257CrossRef
5.
Zurück zum Zitat Migirov L, Wolf M (2013) Endoscopic transcanal stapedotomy: how I do it. Eur Arch Otorhinolaryngol 270:1547–1549CrossRef Migirov L, Wolf M (2013) Endoscopic transcanal stapedotomy: how I do it. Eur Arch Otorhinolaryngol 270:1547–1549CrossRef
6.
Zurück zum Zitat Anschuetz L, Bonali M, Guarino P et al (2017) Management of bleeding in exclusive endoscopic ear surgery: pilot clinical experience. Otolaryngol Head Neck Surg 157:700–706CrossRef Anschuetz L, Bonali M, Guarino P et al (2017) Management of bleeding in exclusive endoscopic ear surgery: pilot clinical experience. Otolaryngol Head Neck Surg 157:700–706CrossRef
7.
Zurück zum Zitat Cornejo-Suarez A, Chavez-Delgado ME, Perez-Ramirez R et al (2019) A modified method of local infiltration for endoscopic stapes surgery: how I do it. Eur Arch Otorhinolaryngol 276:357–365CrossRef Cornejo-Suarez A, Chavez-Delgado ME, Perez-Ramirez R et al (2019) A modified method of local infiltration for endoscopic stapes surgery: how I do it. Eur Arch Otorhinolaryngol 276:357–365CrossRef
8.
Zurück zum Zitat Fisch U (1994) Tympanoplasty, mastoidectomy, and stapes surgery. Thieme Medical Publishers, New York Fisch U (1994) Tympanoplasty, mastoidectomy, and stapes surgery. Thieme Medical Publishers, New York
9.
Zurück zum Zitat Boezaart AP, van der Merwe J, Coetzee A (1995) Comparison of sodium nitroprusside- and esmolol-induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth 42:373–376CrossRef Boezaart AP, van der Merwe J, Coetzee A (1995) Comparison of sodium nitroprusside- and esmolol-induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth 42:373–376CrossRef
10.
Zurück zum Zitat Liu T, Qin M, Li W et al (2016) Effects of a single dose dexmedetomidine on surgical field visibility during middle ear microsurgery: a randomized study. Otol Neurotol 37:680–684CrossRef Liu T, Qin M, Li W et al (2016) Effects of a single dose dexmedetomidine on surgical field visibility during middle ear microsurgery: a randomized study. Otol Neurotol 37:680–684CrossRef
11.
Zurück zum Zitat Iannella G, Magliulo G (2016) Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 37:1350–1357CrossRef Iannella G, Magliulo G (2016) Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 37:1350–1357CrossRef
12.
Zurück zum Zitat Committee on Hearing and Equilibrium Guidelines for the Evaluation of Results of Treatment of Conductive Hearing Loss (1995) American Academy of Otolaryngology-Head and Neck Surgery Foundation I. Otolaryngol Head Neck Surg 113:186–187 Committee on Hearing and Equilibrium Guidelines for the Evaluation of Results of Treatment of Conductive Hearing Loss (1995) American Academy of Otolaryngology-Head and Neck Surgery Foundation I. Otolaryngol Head Neck Surg 113:186–187
13.
Zurück zum Zitat Vincent R, Sperling NM, Oates J et al (2006) Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurotology database. Otol Neurotol 27:25–47CrossRef Vincent R, Sperling NM, Oates J et al (2006) Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurotology database. Otol Neurotol 27:25–47CrossRef
14.
Zurück zum Zitat Liang S, Irwin MG (2010) Review of anesthesia for middle ear surgery. Anesthesiol Clin 28:519–528CrossRef Liang S, Irwin MG (2010) Review of anesthesia for middle ear surgery. Anesthesiol Clin 28:519–528CrossRef
15.
Zurück zum Zitat Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124:266–271CrossRef Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124:266–271CrossRef
Metadaten
Titel
Tympanomeatal flap creation in endoscopic stapedotomy: cautery vs. cold instrumentation
verfasst von
Emine Demir
Metin Çeliker
Gökçe Aydın Balaban
Engin Dursun
Publikationsdatum
12.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 4/2020
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-05847-6

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