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Comparison of endoscopic vs microscopic ossiculoplasty: a study of 157 consecutive cases

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The relatively new technique of trans-canal endoscopic ear surgery (TEES) when compared to microsurgery for ossiculoplasty has advantages of better visualization and no external incision but also has the disadvantage of being a one-handed procedure. Our study aimed to compare audiometric outcomes following ossiculoplasty performed via TESS with results of microsurgery.

Materials and methods

Data from a prospective audit of 157 consecutive patients who underwent ossiculoplasty by a single otologist from 2009 to 2018 was analyzed. TEES was introduced in the department in 2014; therefore, all patients before this period underwent microsurgery. Patients were classified by surgical approach, TEES, or microsurgery. Audiological outcomes were recorded at 3 and 12 months postoperatively and compared to pre-operative levels. Other variables included were the condition of stapes and reconstruction material used.

Results

Of the 157 cases, 50 were TEES and 107 were microsurgery (81 microscope only and 27 combined with endoscope). There was statistically significant improvement (p < 0.001) in AC (43.4 dB pre-operatively, 36.2 dB postoperatively), BC (20.3 dB pre-operatively, 17.6 dB postoperatively), and ABG (21.8 dB pre-operatively, 16.7 dB postoperatively) in the total cohort.

Both groups achieved an ABG better than 20 dB; 72% in TEES, 73% in the microscopic group, and there was no significant difference. There was no change in hearing at 12 months when compared to 3 months. No statistically significant difference was noted based on stapes condition, type of material used for ossiculoplasty, or tympanic membrane graft.

Conclusion

TEES is safe and as effective as microsurgery in ossiculoplasty with possibly much less pain and morbidity.

Level of evidence

3.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Ear, Nose, and Throat Surgery, University Hospital Monklands, North Lanarkshire, Airdrie, ML6 0JS, UK

    Holli Coleman, Theofano Tikka, John Curran & Arunachalam Iyer

Authors
  1. Holli Coleman
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  2. Theofano Tikka
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  3. John Curran
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  4. Arunachalam Iyer
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Contributions

All authors have contributed to the study conception and design. Material preparation, data collection, and analysis were performed by AI, TT, JC, and HC. The first draft of the manuscript was written by HC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Arunachalam Iyer.

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Conflict of interest

All authors certify that they have no affiliations with 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.

Ethical approval

Ethical approval was waived by the local Ethics Committee of University hospital Monklands in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Coleman, H., Tikka, T., Curran, J. et al. Comparison of endoscopic vs microscopic ossiculoplasty: a study of 157 consecutive cases. Eur Arch Otorhinolaryngol 280, 89–96 (2023). https://doi.org/10.1007/s00405-022-07451-2

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  • DOI: https://doi.org/10.1007/s00405-022-07451-2

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