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Endoscopic stapes surgery outcomes and complication rates: a systematic review

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Abstract

Objective

These days, the gold standard procedure for otosclerosis treatment is stapes surgery. The endoscopic approach of the procedure is gaining popularity as endoscopic ear surgery develops across the globe. The main objective of this study is to gather and compile well-documented and reliable data regarding surgical outcomes for the endoscopic approach to stapes surgery up to this date.

Materials and methods

Publications in English were searched in the PUBMED/MEDLINE database and were systematically reviewed. A total of 16 articles were reviewed according to the inclusion criteria, obtaining a total of 573 patients managed surgically for otosclerosis, using an endoscopic approach. Data were systematically extracted and compared across variables.

Results

Data were obtained as follows: mean age of 43 years; female proportion of 60%; 3 mm endoscope diameter of 51%, 4 mm of 39%; titanium piston-type prostheses of 52% and Teflon of 48%; length of the prosthesis (mode) was 4.5 mm; 0.6 mm diameter of the piston of 81% and 0.4 mm of 19%; mean surgical time was 55 min. Hearing results, mean preoperative air–bone gap (ABG) 31 dB; mean postoperative ABG 9 dB; ABG improvement of 22 dB; an ABG closure rate to 20 dB or less of 92% and an ABG closure rate to 10 dB or less of 77%. Complication rates: intraoperative tympanic membrane perforation of 5%; postoperative vertigo of 11%; postoperative dysgeusia of 10%; reported a postoperative neurosensorial hearing loss of 0.2%; reported gusher phenomenon of one case (0.2%).

Conclusion

Endoscopic stapes surgery is completely achievable using 0º angle and 4-mm-diameter sinus surgery endoscope. Instrument availability should not be an obstacle to the development of this type of surgery in any otolaryngology department. Audiological outcomes are comparable to microscopic approaches.

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References

  1. Isaacson B, Hunter JB, Rivas A (2018) Endoscopic stapes surgery. Otolaryngol Clin North Am 51(2):415–428. https://doi.org/10.1016/j.otc.2017.11.011

    Article  PubMed  Google Scholar 

  2. Nassiri AM, Yawn RJ, Dedmon MM et al (2018) Primary endoscopic stapes surgery: audiologic and surgical outcomes. Otol Neurotol 39(9):1095–1101. https://doi.org/10.1097/MAO.0000000000001958

    Article  PubMed  Google Scholar 

  3. Hunter JB, Rivas A (2016) Outcomes following endoscopic stapes surgery. Otolaryngol Clin North Am 49(5):1215–1225. https://doi.org/10.1016/j.otc.2016.05.012

    Article  PubMed  Google Scholar 

  4. Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124(1):266–271. https://doi.org/10.1002/lary.24144

    Article  PubMed  Google Scholar 

  5. Iannella G, Marcotullio D, Re M et al (2017) Endoscopic vs microscopic approach in stapes surgery: advantages in the middle ear structures visualization and trainee’s point of view. J Int Adv Otol 13(1):14–20. https://doi.org/10.5152/iao.2017.3322

    Article  PubMed  Google Scholar 

  6. Sproat R, Yiannakis C, Iyer A (2017) Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol 38(5):662–666. https://doi.org/10.1097/MAO.0000000000001371

    Article  PubMed  Google Scholar 

  7. Hunter JB, O'Connell BP, Rivas A (2016) Endoscopic techniques in tympanoplasty and stapes surgery. Curr Opin Otolaryngol Head Neck Surg 24(5):388–394. https://doi.org/10.1097/MOO.0000000000000297

    Article  PubMed  Google Scholar 

  8. Bartel R, Levorato M, Adroher M et al (2019) Transcanal endoscopic type 1 tympanoplasty in children: cartilage butterfly and fascia temporalis graft. Int J Pediatr Otorhinolaryngol 121:120–122. https://doi.org/10.1016/j.ijporl.2019.03.012

    Article  CAS  PubMed  Google Scholar 

  9. Bianconi L, Gazzini L, Laura E, De Rossi S, Conti A, Marchioni D (2020) Endoscopic stapedotomy: safety and audiological results in 150 patients. Eur Arch Otorhinolaryngol 277(1):85–92. https://doi.org/10.1007/s00405-019-05688-y

    Article  PubMed  Google Scholar 

  10. Gulsen S, Karatas E (2019) Comparison of surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery. Pak J Med Sci 35(5):1387–1391. https://doi.org/10.12669/pjms.35.5.439

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pradhan P, Preetam C (2019) Endoscopic stapedotomy: a comparison between 4 mm and 3 mm nasal endoscope. Eur Arch Otorhinolaryngol 276(11):3035–3041. https://doi.org/10.1007/s00405-019-05592-5

    Article  PubMed  Google Scholar 

  12. Moneir W, Abd El-Fattah AM, Mahmoud E, Elshaer M (2018) Endoscopic stapedotomy: merits and demerits. J Otol 13(3):97–100

    Article  Google Scholar 

  13. Bhardwaj A, Anant A, Bharadwaj N, Gupta A, Gupta S (2018) Stapedotomy using a 4 mm endoscope: any advantage over a microscope? J Laryngol Otol 132(9):807–811. https://doi.org/10.1017/S0022215118001548

    Article  CAS  PubMed  Google Scholar 

  14. Kuo CW, Wu HM (2018) Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 138(10):871–876. https://doi.org/10.1080/00016489.2018.1490029

    Article  PubMed  Google Scholar 

  15. Ardiç FN, Aykal K, Tümkaya F, Kara CO, Barlay F (2018) Improvement of hearing results by bone cement fixation in endoscopic stapedotomy. J Laryngol Otol 132(6):486–488. https://doi.org/10.1017/S0022215118000439

    Article  PubMed  Google Scholar 

  16. 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. https://doi.org/10.1097/MAO.0000000000001186

    Article  PubMed  Google Scholar 

  17. 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. https://doi.org/10.1016/j.anl.2016.07.001

    Article  PubMed  Google Scholar 

  18. Naik C, Nemade S (2016) Endoscopic stapedotomy: our view point. Eur Arch Otorhinolaryngol 273(1):37–41. https://doi.org/10.1007/s00405-014-3468-6

    Article  PubMed  Google Scholar 

  19. Migirov L, Wolf M (2013) Endoscopic transcanal stapedotomy: how I do it. Eur Arch Otorhinolaryngol 270(4):1547–1549. https://doi.org/10.1007/s00405-013-2420-5

    Article  PubMed  Google Scholar 

  20. Nogueira Junior JF, Martins MJ, Aguiar CV et al (2011) Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 77(6):721–727

    Article  Google Scholar 

  21. Tarabichi M (1999) Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol 108(1):39–46

    Article  CAS  Google Scholar 

  22. Daneshi A, Jahandideh H (2016) Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngo 273(3):631–634

    Article  Google Scholar 

  23. Nikolaos T, Aikaterini T, Dimitrios D, Sarantis B, John G, Eleana T, Konstantinos M (2018) Does endoscopic stapedotomy increase hearing restoration rates comparing to microscopic? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 275(12):2905–2913

    Article  Google Scholar 

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The authors certify that they have no affiliations or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain

    Ricardo Bartel, Juan Jose Sanz, Ignacio Clemente, Gabriela Simonetti, Guillem Viscacillas, Laura Palomino, Isabel Asarta & Xavier Lao

  2. Otology Research Group of Young Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France

    Ricardo Bartel

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  1. Ricardo Bartel
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  2. Juan Jose Sanz
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  3. Ignacio Clemente
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  4. Gabriela Simonetti
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Correspondence to Ricardo Bartel.

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Bartel, R., Sanz, J.J., Clemente, I. et al. Endoscopic stapes surgery outcomes and complication rates: a systematic review. Eur Arch Otorhinolaryngol 278, 2673–2679 (2021). https://doi.org/10.1007/s00405-020-06388-8

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  • DOI: https://doi.org/10.1007/s00405-020-06388-8

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