Abstract
Objectives:
(1) Describe basic and essential surgical steps of the endoscopic-assisted approach to stapedotomy. (2) Analyze advantages and disadvantages of the endoscopic technique. (3) Compare the outcomes of the endoscopic-assisted stapedotomy with those obtained with the traditional microscopic approach.
Methods:
The study was conducted from September 2011 to September 2013 at the ENT University Unit of the “A. Fiorini” Hospital, Sapienza University of Rome. Thirty patients (average age 47.5 years, 11 males, 19 females, 30 ears) with clinical otosclerosis undergoing stapedotomy under general anesthesia were enrolled in this prospective, controlled trial. Patients were randomly divided into 2 groups. Group A patients underwent stapedotomy under endoscopic viewing, whereas in Group B the same procedure was traditionally performed using a surgical microscope. The endoscopic set, originally used for endoscopic sinus surgery, included a 3 mm 0° endoscope, a 3CCD camera, and a video monitor. All procedures were performed by the same surgeon and the surgical steps were recorded. Videos were analyzed to compare the details of the anatomical structures in the operative field. Surgical times, functional results, and complications were recorded.
Results:
Functional results were comparable in both groups (air-bone gap ≤20 dB). No complications occurred. Surgical times were significantly longer in Group A (P < .05).
Conclusions:
Endoscopic stapedotomy is a feasible, viable alternative to traditional stapes surgery performed with the microscopic approach. The use of endoscopes improve the visualization of the operative field and allow a detailed view of the anatomical structures in an educational perspective.
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