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A modified method of local infiltration for endoscopic stapes surgery: how I do it

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

Abstract

Purpose

To present a modified method of local infiltration (MMLI) for endoscopic stapes surgery to reduce surgical time, bleeding and complications.

Materials and methods

This study involved 70 patients who underwent stapes surgery for otosclerosis by endoscopic and microscopic approaches. The MMLI was applied as follows: local infiltration was performed with one hand while the other hand inserted the endoscope into the ear canal to observe vasoconstriction signs on the monitor; the single site of infiltration was located at the center of the anterior conchal cartilage. Operative time, intraoperative blood loss, preservation of anatomical structures, postoperative hearing and complications were evaluated.

Results

The MMLI allowed for quick bleeding control and a clear and dry operative field. Operative time, intraoperative blood loss and preservation of anatomical structures were significantly reduced in the endoscopic group (P < 0.00) versus the microscopic group. The scutum was removed less frequent in the endoscopic group 7.1% versus 53.6% of the microscopic group (P < 0.00). The chorda tympani was preserved in all cases but it was more manipulated in the microscopic group 39.3% versus 9.5% of the endoscopic group (P < 0.00). No complications were observed and the hearing outcomes were significantly better than the preoperative thresholds.

Conclusions

This is the first report on the use of a MMLI for endoscopic stapes surgery. Using this method, the surgeon performs the infiltration at one site and concurrently observes the vasoconstriction signs without the use of a microscope, frontal lamp or speculum. This method provides benefits in terms of operative time and complications.

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Abbreviations

MMLI:

Modified method of local infiltration

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Acknowledgements

The authors thank Guillermo Aguirre for their valuable help with the figures and photographic material. In addition, the authors thank Jessica Bañuelos Cornejo for her drawings.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Grupo ARCOSCEO “Cirugía endoscópica del oído e investigación”, Guadalajara, Jalisco, Mexico

    Arnulfo Cornejo-Suarez

  2. Department of Otorhinolaryngology and Research, Hospital Central Quirúrgica, Av. España 1661, entre Bélgica y Argentina, Col. Moderna, Sector Hidalgo, CP 44190, Guadalajara, Jalisco, Mexico

    Maria Estela Chavez-Delgado

  3. Department of Otorhinolaryngology, Hospital General Zona 1, Instituto Mexicano Del Seguro Social (IMSS), Aguascalientes, Aguascalientes, Mexico

    Ramon Perez-Ramirez

  4. Department of Otorhinolaryngology, Unidad Medica Alta Especialidad (UMAE) 71, IMSS, Torreón, Coahuila, Mexico

    Isaac Montoya-Hernandez

  5. Department of Otorhinolaryngology, Hospital Angeles, Torreón, Coahuila, Mexico

    Jose Regino Montoya-Valdez

  6. Department of Otorhinolaryngology, Hospital Zona 3, IMSS, Cancún, Quintana Roo, Mexico

    Carlos Silvino Rosales-Orozco

  7. Department of Otorhinolaryngology and Head Neck Surgery, UMAE, IMSS, Guadalajara, Jalisco, Mexico

    Luis Humberto Govea-Camacho

  8. Grupo ARCOSCEO “Cirugía endoscópica del oído e investigación”, Alfonso Reyes 428, Colinas de la Normal, CP44270, Guadalajara, Jalisco, Mexico

    Maria Estela Chavez-Delgado, Ramon Perez-Ramirez, Isaac Montoya-Hernandez, Jose Regino Montoya-Valdez, Carlos Silvino Rosales-Orozco & Luis Humberto Govea-Camacho

Authors
  1. Arnulfo Cornejo-Suarez
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  2. Maria Estela Chavez-Delgado
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  3. Ramon Perez-Ramirez
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  4. Isaac Montoya-Hernandez
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  5. Jose Regino Montoya-Valdez
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  6. Carlos Silvino Rosales-Orozco
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  7. Luis Humberto Govea-Camacho
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Corresponding author

Correspondence to Maria Estela Chavez-Delgado.

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The author(s) declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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Cornejo-Suarez, A., Chavez-Delgado, M.E., Perez-Ramirez, R. et al. A modified method of local infiltration for endoscopic stapes surgery: how I do it. Eur Arch Otorhinolaryngol 276, 357–365 (2019). https://doi.org/10.1007/s00405-018-5238-3

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  • DOI: https://doi.org/10.1007/s00405-018-5238-3

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