Abstract
Objective
The most widely accepted treatment for otosclerosis is currently microscopic stapes surgery under either local or general anesthesia. The aim of the study is to describe the surgical steps in endoscopic stapes surgery and to evaluate the audiologic and surgical outcomes.
Materials and methods
All patients who underwent exclusive endoscopic stapes surgery or revision surgery for previous stapedotomy between November 2014 and September 2018 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure tone averages and air bone gaps, intraoperative and postoperative complications and follow-up data were summarized and gathered in a database for further consideration and analysis.
Results
In the period examined, 181 stapes surgical procedures were performed and out of these 150 met the inclusion criteria. There were no cases of major intraoperative complications. Sensorineural hearing loss was observed in one case. In one patient a gusher effect occurred during surgery. The postoperative air–bone gap improved significantly compared to the preoperative gap (8 vs 29 dB HL, respectively), and the mean air–bone gap closure was 20 dB HL. In 78.7% of cases, the observed postoperative air–bone gap was less than 10 dB HL and in 14% it was between 11 dB HL and 20 dB HL. An ABG closure lower than 20 dB HL was achieved in a total of 92.7% of patients.
Conclusions
Endoscopic stapes surgery is a safe procedure with a low risk of peri- or postoperative complications and is a possible alternative to the traditional microscopic surgical procedure in the treatment of otosclerosis.
Similar content being viewed by others
References
Batson L, Rizzolo D (2017) Otosclerosis: an update on diagnosis and treatment. JAAPA. 30(2):17–22
Dhooge I, Desmedt S, Maly T, Loose D, Van Hoecke H (2018) Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol. 275(5):1111–1119
Alzhrani F, Mokhatrish MM, Al-Momani MO, Alshehri H, Hagr A, Garadat SN (2017) Effectiveness of stapedotomy in improving hearing sensitivity for 53 otosclerotic patients: Retrospective review. Ann Saudi Med. 37(1):49–55
Hunter JB, O′Connell BP, Rivas A (2017) Transcanal endoscopic stapedotomy. Operative techniques. Otolaryngol Head Neck Surg 28(1):44–49
Dursun E, Özgür A, Terzi S, Oğurlu M, Coşkun ZO, Demirci M (2016) Endoscopic transcanal stapes surgery: our technique and outcomes. Kulak Burun Bogaz Ihtis Derg. 26(4):201–206
Hunter JB, Rivas A (2016) Outcomes following endoscopic stapes surgery. Otolaryngol Clin N Am 49:1215–1225
Özdek A, Bayir Ö, Keseroğlu K et al (2016) Fully endoscopic stapes surgery: preliminary results. Ann Otolaryngol Rhinol 3(1):1085
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, Inc. Otolaryngol Head Neck Surg 113(3):186–187
Sproat R, Yiannakis C, Iyer A (2017) Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol. 38(5):662–666
Vincent R, Sperling NM, Oates J, Jindal M (2006) Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurology database. Otol Neurotol 27(8 Suppl 2):S25–S47
Kisilevsky VE, Dutt SN, Bailie NA, Halik JJ (2009) Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots. J Laryngol Otol 123(7):730–736
Justicz N, Strickland KF, Motamedi KK, Mattox DE (2017) Review of a single surgeon’s stapedotomy cases with a nickel titanium prosthesis over a 14-year period. Acta Otolaryngol 137(4):442–446
Strӧmbӓck K, Lundman L, Bjorsne A, Grendin J, Stjernquist-Desatnik A, Dahlin-Redfors Y (2017) Stapes surgery in Sweden: evaluation of a national-based register. Eur Arch Otorhinolaryngol 274(6):2421–2427
Parida PK, Kalaiarasi R, Gopalakrishnan S (2016) Diode laser stapedotomy vs conventional stapedotomy in otosclerosis: a double-blinded randomized clinical trial. Otolaryngol Head Neck Surg 154(6):1099–1105
Parrilla C, Gall J, Fetoni AR, Rigante M, Paludetti G (2008) Erbium: yttrium–aluminium–garnet laser stapedotomy—a safe technique. Otolaryngol Head Neck Surg 138(4):507–512
Aarnisalo AA, Vasama JP, Hopsu E, Ramsay H (2003) Long-term hearing results after stapes surgery: a 20-year follow-up. Otol Neurotol 24(4):567–571
Marchese MR, Cianfrone F, Passali GC, Paludetti G (2007) Hearing results after stapedotomy: role of the prosthesis diameter. Audiol Neurootol 12(4):221–225
Murfee J, O’Connell B, Haynes D, Rivas A, Dedmon M, Bennett M (2018) Outcomes of stapedotomy with heat-crimped prostheses. Otol Neurotol 39(10):1235–1240
Vincent R, Rovers M, Zingade N et al (2010) Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from Otology-Neurotology Database. Otol Neurotol 31(6):875–882
Moneir W, Abd El-Fattah AM, Mahmoud E, Elshaer M (2018) Endoscopic stapedotomy: merits and demerits. J Otol. 13(3):97–100
Surmelioglu O, Ozdemir S, Tarkan O, Tuncer U, Dagkiran M, Cetik F (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44(3):253–257
Quaranta N, Besozzi G, Fallacara RA, Quaranta A (2005) Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis. Otolaryngol Head Neck Surg 133(1):116–120
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(9):1350–1357
Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124(1):266–271
Daneshi A, Jahandideh H (2016) Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngol 273(3):631–634
Adedeji TO, Indorewala S, Indorewala A, Nemade G (2016) Stapedotomy and its effect on hearing—our experience with 54 cases. Afr Health Sci. 16(1):276–281
Somers T, Govaerts P, de Varebeke SJ, Offeciers E (1997) Revision stapes surgery. J Laryngol Otol 111(3):233–239
Farrior J, Sutherland A (1991) Revision stapes surgery. Laryngoscope 101(11):1155–1161
Gros A, Vatovec J, Zargi M, Jenko K (2005) Success rate in revision stapes surgery for otosclerosis. Otol Neurotol 26(6):1143–1148
Sedwick JD, Louden CL, Shelton C (1997) Stapedectomy vs stapedotomy. Do you really need a laser? Arch Otolaryngol Head Neck Surg 123(2):177–180
Mahfudz Z, Lokman S (2004) Outcome of stapes surgery for otosclerosis. Med J Malay 59(2):171–176
Dundar R, Bulut H, Güler OK et al (2015) Oval window temperature changes in an endoscopic stapedectomy. J Craniofac Surg 26(5):1704–1708
Marchioni D, Rubini A, Gazzini L et al (2018) Complications in endoscopic ear surgery. Otol Neurotol 39(8):1012–1017
Ito T, Kubota T, Takagi A et al (2016) Safety of heat generated by endoscope light sources in simulated transcanal endoscopic ear surgery. Auris Nasus Larynx 43(5):501–506
Marchioni D, Soloperto D, Villari D et al (2016) Stapes malformations: the contribute of the endoscopy for diagnosis and surgery. Eur Arch Otorhinolaryngol 273(7):1723–1729
Funding
This study was not funded.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The present authors have no financial relationships to disclose.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study. All of the authors have read and approved the manuscript.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bianconi, L., Gazzini, L., Laura, E. et al. Endoscopic stapedotomy: safety and audiological results in 150 patients. Eur Arch Otorhinolaryngol 277, 85–92 (2020). https://doi.org/10.1007/s00405-019-05688-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-019-05688-y