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

  • Otology
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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.

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References

  1. Kuo CW, Wu HM (2018) Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 138:871–876

    Article  Google Scholar 

  2. Poe DS (2000) Laser-assisted endoscopic stapedectomy: a prospective study. Laryngoscope 110:1–37

    Article  CAS  Google Scholar 

  3. Nogueira Junior JF, Martins MJ, Aguiar CV et al (2011) Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 77:721–727

    Article  Google Scholar 

  4. Surmelioglu O, Ozdemir S, Tarkan O et al (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44:253–257

    Article  Google Scholar 

  5. Migirov L, Wolf M (2013) Endoscopic transcanal stapedotomy: how I do it. Eur Arch Otorhinolaryngol 270:1547–1549

    Article  Google Scholar 

  6. Anschuetz L, Bonali M, Guarino P et al (2017) Management of bleeding in exclusive endoscopic ear surgery: pilot clinical experience. Otolaryngol Head Neck Surg 157:700–706

    Article  Google Scholar 

  7. 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 276:357–365

    Article  Google Scholar 

  8. Fisch U (1994) Tympanoplasty, mastoidectomy, and stapes surgery. Thieme Medical Publishers, New York

    Google Scholar 

  9. 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 42:373–376

    Article  CAS  Google Scholar 

  10. 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 37:680–684

    Article  CAS  Google Scholar 

  11. 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 37:1350–1357

    Article  Google Scholar 

  12. 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. 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 27:25–47

    Article  Google Scholar 

  14. Liang S, Irwin MG (2010) Review of anesthesia for middle ear surgery. Anesthesiol Clin 28:519–528

    Article  Google Scholar 

  15. Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124:266–271

    Article  Google Scholar 

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Correspondence to Emine Demir.

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All authors confirm that no conflict of interest.

Research involving human participants

Yes [the study was conducted in accordance with the ethical standards stated in the ‘Declaration of Helsinki’, and was approved by the local ethics committee (protocol number: 2019/147)].

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None, because this study is retrospective and there are only file scanned.

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Demir, E., Çeliker, M., Balaban, G.A. et al. Tympanomeatal flap creation in endoscopic stapedotomy: cautery vs. cold instrumentation. Eur Arch Otorhinolaryngol 277, 1061–1066 (2020). https://doi.org/10.1007/s00405-020-05847-6

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  • DOI: https://doi.org/10.1007/s00405-020-05847-6

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