Endoscopic stapedotomy: Merits and demerits.

Introduction: Surgical microscopes are still preferred to perform stapes surgery; but the use of the endoscopes would offer much benefits such as good panoramic view and easy accessibility to the oval window niche, the stapes and facial nerve. In this study, we aimed to analyze and compare the outcomes and complications of endoscopic versus microscopic stapes surgery.

Patients And Methods: This work was done at the Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt, between September 2015 and July 2016. The patients; diagnosed as having otosclerosis and full filled the selection criteria; were randomly divided into 2 groups.

Results: The group A (microscopic group) included 28 patients (aged 19-60 years) and the group B (endoscopic group) included 14 patients (aged 22-56 years). Mean follow-up durations were 4.5 months (1-8.5) in the endoscopic group and 5.5 months (1.5-8) in the microscopic group. The difference in preoperative and postoperative air-bone gap in two groups was statistically significant (p = 0.031). But there was no statistical difference for hearing results between two groups and the two techniques have similar audiological outcomes. The main merits of endoscopic stapedotomy are the good quality panoramic image, well identification and visualization of vital structures of the middle ear, minimal handling of chorda tympani nerve if needed with practically no curettage of bony wall.

Conclusions: The present series shows that it is possible to perform stapes surgery using only the 4mm in diameter and 18cm long endoscopes of different angulations, without major difficulties.