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Stapedotomy using a 4 mm endoscope: any advantage over a microscope?

Published online by Cambridge University Press:  10 September 2018

A Bhardwaj ,
A Anant ,
N Bharadwaj ,
A Gupta  and
S Gupta
A Bhardwaj*
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
A Anant
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
N Bharadwaj
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
A Gupta
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
S Gupta
Affiliation:
Department of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
*
Author for correspondence: Dr Abhishek Bhardwaj, Dept. of ENT, Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India E-mail: abhi04stanley@gmail.com Fax: +91 11 2616 3072
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Abstract

Objectives

To ascertain the feasibility of endoscopic (4 mm) stapedotomy, and compare intra- and post-operative variations with microscopic stapedotomies.

Methods

Forty otosclerosis patients were scheduled for microscopic or endoscopic stapedotomy. Intra-operative variables compared were: incision, canalplasty, canal wall curettage for ossicular assessment, chorda tympani manipulation, ability to perform stapes footplate perforation before its supra-structure removal, and operative time. Post-operative variables compared were ear pain and hearing improvement.

Results

Of the 20 microscopy patients, 4 required endaural incision and canalplasty because of canal overhangs, and 7 required canal wall curettage for ossicular assessment. None of the 20 endoscopy patients required these procedures. Chorda tympani was manipulated in 13 and 6 patients in the microscopy and endoscopy groups respectively, while the stapes footplate could be perforated in 5 and 11 patients respectively. Mean operative time was 50.25 and 76.05 minutes in the microscopy and endoscopy groups respectively. In the endoscopy group, mean air–bone gap was 37.12 and 10.73 dB pre- and post-operation respectively; in the microscopy group, these values were 35.95 and 13.81 dB.

Conclusion

Endoscopic stapedotomy has comparable hearing outcomes. Sinonasal endoscope serves as a better tool for: minimal incision, canalplasty avoidance, less chorda tympani mobilisation, and stapes footplate perforation ability.

Keywords

EndoscopesOtosclerosisStapes SurgeryMicroscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 807 - 811
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr A Bhardwaj takes responsibility for the integrity of the content of the paper

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