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Published in: European Archives of Oto-Rhino-Laryngology 1/2020

01-01-2020 | Otosclerosis | Otology

Endoscopic stapedotomy: safety and audiological results in 150 patients

Authors: Luca Bianconi, Luca Gazzini, Elisa Laura, Stefano De Rossi, Alessandro Conti, Daniele Marchioni

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2020

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Abstract

Objective

The most widely accepted treatment for otosclerosis is currently microscopic stapes surgery under either local or general anesthesia. The aim of the study is to describe the surgical steps in endoscopic stapes surgery and to evaluate the audiologic and surgical outcomes.

Materials and methods

All patients who underwent exclusive endoscopic stapes surgery or revision surgery for previous stapedotomy between November 2014 and September 2018 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure tone averages and air bone gaps, intraoperative and postoperative complications and follow-up data were summarized and gathered in a database for further consideration and analysis.

Results

In the period examined, 181 stapes surgical procedures were performed and out of these 150 met the inclusion criteria. There were no cases of major intraoperative complications. Sensorineural hearing loss was observed in one case. In one patient a gusher effect occurred during surgery. The postoperative air–bone gap improved significantly compared to the preoperative gap (8 vs 29 dB HL, respectively), and the mean air–bone gap closure was 20 dB HL. In 78.7% of cases, the observed postoperative air–bone gap was less than 10 dB HL and in 14% it was between 11 dB HL and 20 dB HL. An ABG closure lower than 20 dB HL was achieved in a total of 92.7% of patients.

Conclusions

Endoscopic stapes surgery is a safe procedure with a low risk of peri- or postoperative complications and is a possible alternative to the traditional microscopic surgical procedure in the treatment of otosclerosis.
Literature
1.
go back to reference Batson L, Rizzolo D (2017) Otosclerosis: an update on diagnosis and treatment. JAAPA. 30(2):17–22CrossRef Batson L, Rizzolo D (2017) Otosclerosis: an update on diagnosis and treatment. JAAPA. 30(2):17–22CrossRef
2.
go back to reference Dhooge I, Desmedt S, Maly T, Loose D, Van Hoecke H (2018) Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol. 275(5):1111–1119CrossRef Dhooge I, Desmedt S, Maly T, Loose D, Van Hoecke H (2018) Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol. 275(5):1111–1119CrossRef
3.
go back to reference Alzhrani F, Mokhatrish MM, Al-Momani MO, Alshehri H, Hagr A, Garadat SN (2017) Effectiveness of stapedotomy in improving hearing sensitivity for 53 otosclerotic patients: Retrospective review. Ann Saudi Med. 37(1):49–55CrossRef Alzhrani F, Mokhatrish MM, Al-Momani MO, Alshehri H, Hagr A, Garadat SN (2017) Effectiveness of stapedotomy in improving hearing sensitivity for 53 otosclerotic patients: Retrospective review. Ann Saudi Med. 37(1):49–55CrossRef
4.
go back to reference Hunter JB, O′Connell BP, Rivas A (2017) Transcanal endoscopic stapedotomy. Operative techniques. Otolaryngol Head Neck Surg 28(1):44–49CrossRef Hunter JB, O′Connell BP, Rivas A (2017) Transcanal endoscopic stapedotomy. Operative techniques. Otolaryngol Head Neck Surg 28(1):44–49CrossRef
5.
go back to reference Dursun E, Özgür A, Terzi S, Oğurlu M, Coşkun ZO, Demirci M (2016) Endoscopic transcanal stapes surgery: our technique and outcomes. Kulak Burun Bogaz Ihtis Derg. 26(4):201–206CrossRef Dursun E, Özgür A, Terzi S, Oğurlu M, Coşkun ZO, Demirci M (2016) Endoscopic transcanal stapes surgery: our technique and outcomes. Kulak Burun Bogaz Ihtis Derg. 26(4):201–206CrossRef
6.
go back to reference Hunter JB, Rivas A (2016) Outcomes following endoscopic stapes surgery. Otolaryngol Clin N Am 49:1215–1225CrossRef Hunter JB, Rivas A (2016) Outcomes following endoscopic stapes surgery. Otolaryngol Clin N Am 49:1215–1225CrossRef
7.
go back to reference Özdek A, Bayir Ö, Keseroğlu K et al (2016) Fully endoscopic stapes surgery: preliminary results. Ann Otolaryngol Rhinol 3(1):1085 Özdek A, Bayir Ö, Keseroğlu K et al (2016) Fully endoscopic stapes surgery: preliminary results. Ann Otolaryngol Rhinol 3(1):1085
8.
go back to reference Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss (1995) American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 113(3):186–187 Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss (1995) American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 113(3):186–187
9.
go back to reference Sproat R, Yiannakis C, Iyer A (2017) Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol. 38(5):662–666CrossRef Sproat R, Yiannakis C, Iyer A (2017) Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol. 38(5):662–666CrossRef
10.
go back to reference Vincent R, Sperling NM, Oates J, Jindal M (2006) Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurology database. Otol Neurotol 27(8 Suppl 2):S25–S47CrossRef Vincent R, Sperling NM, Oates J, Jindal M (2006) Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurology database. Otol Neurotol 27(8 Suppl 2):S25–S47CrossRef
11.
go back to reference Kisilevsky VE, Dutt SN, Bailie NA, Halik JJ (2009) Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots. J Laryngol Otol 123(7):730–736CrossRef Kisilevsky VE, Dutt SN, Bailie NA, Halik JJ (2009) Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots. J Laryngol Otol 123(7):730–736CrossRef
12.
go back to reference Justicz N, Strickland KF, Motamedi KK, Mattox DE (2017) Review of a single surgeon’s stapedotomy cases with a nickel titanium prosthesis over a 14-year period. Acta Otolaryngol 137(4):442–446CrossRef Justicz N, Strickland KF, Motamedi KK, Mattox DE (2017) Review of a single surgeon’s stapedotomy cases with a nickel titanium prosthesis over a 14-year period. Acta Otolaryngol 137(4):442–446CrossRef
13.
go back to reference Strӧmbӓck K, Lundman L, Bjorsne A, Grendin J, Stjernquist-Desatnik A, Dahlin-Redfors Y (2017) Stapes surgery in Sweden: evaluation of a national-based register. Eur Arch Otorhinolaryngol 274(6):2421–2427CrossRef Strӧmbӓck K, Lundman L, Bjorsne A, Grendin J, Stjernquist-Desatnik A, Dahlin-Redfors Y (2017) Stapes surgery in Sweden: evaluation of a national-based register. Eur Arch Otorhinolaryngol 274(6):2421–2427CrossRef
14.
go back to reference Parida PK, Kalaiarasi R, Gopalakrishnan S (2016) Diode laser stapedotomy vs conventional stapedotomy in otosclerosis: a double-blinded randomized clinical trial. Otolaryngol Head Neck Surg 154(6):1099–1105CrossRef Parida PK, Kalaiarasi R, Gopalakrishnan S (2016) Diode laser stapedotomy vs conventional stapedotomy in otosclerosis: a double-blinded randomized clinical trial. Otolaryngol Head Neck Surg 154(6):1099–1105CrossRef
15.
go back to reference Parrilla C, Gall J, Fetoni AR, Rigante M, Paludetti G (2008) Erbium: yttrium–aluminium–garnet laser stapedotomy—a safe technique. Otolaryngol Head Neck Surg 138(4):507–512CrossRef Parrilla C, Gall J, Fetoni AR, Rigante M, Paludetti G (2008) Erbium: yttrium–aluminium–garnet laser stapedotomy—a safe technique. Otolaryngol Head Neck Surg 138(4):507–512CrossRef
16.
go back to reference Aarnisalo AA, Vasama JP, Hopsu E, Ramsay H (2003) Long-term hearing results after stapes surgery: a 20-year follow-up. Otol Neurotol 24(4):567–571CrossRef Aarnisalo AA, Vasama JP, Hopsu E, Ramsay H (2003) Long-term hearing results after stapes surgery: a 20-year follow-up. Otol Neurotol 24(4):567–571CrossRef
17.
go back to reference Marchese MR, Cianfrone F, Passali GC, Paludetti G (2007) Hearing results after stapedotomy: role of the prosthesis diameter. Audiol Neurootol 12(4):221–225CrossRef Marchese MR, Cianfrone F, Passali GC, Paludetti G (2007) Hearing results after stapedotomy: role of the prosthesis diameter. Audiol Neurootol 12(4):221–225CrossRef
18.
go back to reference Murfee J, O’Connell B, Haynes D, Rivas A, Dedmon M, Bennett M (2018) Outcomes of stapedotomy with heat-crimped prostheses. Otol Neurotol 39(10):1235–1240CrossRef Murfee J, O’Connell B, Haynes D, Rivas A, Dedmon M, Bennett M (2018) Outcomes of stapedotomy with heat-crimped prostheses. Otol Neurotol 39(10):1235–1240CrossRef
19.
go back to reference Vincent R, Rovers M, Zingade N et al (2010) Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from Otology-Neurotology Database. Otol Neurotol 31(6):875–882CrossRef Vincent R, Rovers M, Zingade N et al (2010) Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from Otology-Neurotology Database. Otol Neurotol 31(6):875–882CrossRef
20.
go back to reference Moneir W, Abd El-Fattah AM, Mahmoud E, Elshaer M (2018) Endoscopic stapedotomy: merits and demerits. J Otol. 13(3):97–100CrossRef Moneir W, Abd El-Fattah AM, Mahmoud E, Elshaer M (2018) Endoscopic stapedotomy: merits and demerits. J Otol. 13(3):97–100CrossRef
21.
go back to reference Surmelioglu O, Ozdemir S, Tarkan O, Tuncer U, Dagkiran M, Cetik F (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44(3):253–257CrossRef Surmelioglu O, Ozdemir S, Tarkan O, Tuncer U, Dagkiran M, Cetik F (2017) Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 44(3):253–257CrossRef
22.
go back to reference Quaranta N, Besozzi G, Fallacara RA, Quaranta A (2005) Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis. Otolaryngol Head Neck Surg 133(1):116–120CrossRef Quaranta N, Besozzi G, Fallacara RA, Quaranta A (2005) Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis. Otolaryngol Head Neck Surg 133(1):116–120CrossRef
23.
go back to reference Iannella G, Magliulo G (2016) Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 37(9):1350–1357CrossRef Iannella G, Magliulo G (2016) Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 37(9):1350–1357CrossRef
24.
go back to reference Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124(1):266–271CrossRef Kojima H, Komori M, Chikazawa S et al (2014) Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 124(1):266–271CrossRef
25.
go back to reference Daneshi A, Jahandideh H (2016) Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngol 273(3):631–634CrossRef Daneshi A, Jahandideh H (2016) Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngol 273(3):631–634CrossRef
26.
go back to reference Adedeji TO, Indorewala S, Indorewala A, Nemade G (2016) Stapedotomy and its effect on hearing—our experience with 54 cases. Afr Health Sci. 16(1):276–281CrossRef Adedeji TO, Indorewala S, Indorewala A, Nemade G (2016) Stapedotomy and its effect on hearing—our experience with 54 cases. Afr Health Sci. 16(1):276–281CrossRef
27.
go back to reference Somers T, Govaerts P, de Varebeke SJ, Offeciers E (1997) Revision stapes surgery. J Laryngol Otol 111(3):233–239CrossRef Somers T, Govaerts P, de Varebeke SJ, Offeciers E (1997) Revision stapes surgery. J Laryngol Otol 111(3):233–239CrossRef
28.
go back to reference Farrior J, Sutherland A (1991) Revision stapes surgery. Laryngoscope 101(11):1155–1161CrossRef Farrior J, Sutherland A (1991) Revision stapes surgery. Laryngoscope 101(11):1155–1161CrossRef
29.
go back to reference Gros A, Vatovec J, Zargi M, Jenko K (2005) Success rate in revision stapes surgery for otosclerosis. Otol Neurotol 26(6):1143–1148CrossRef Gros A, Vatovec J, Zargi M, Jenko K (2005) Success rate in revision stapes surgery for otosclerosis. Otol Neurotol 26(6):1143–1148CrossRef
30.
go back to reference Sedwick JD, Louden CL, Shelton C (1997) Stapedectomy vs stapedotomy. Do you really need a laser? Arch Otolaryngol Head Neck Surg 123(2):177–180CrossRef Sedwick JD, Louden CL, Shelton C (1997) Stapedectomy vs stapedotomy. Do you really need a laser? Arch Otolaryngol Head Neck Surg 123(2):177–180CrossRef
31.
go back to reference Mahfudz Z, Lokman S (2004) Outcome of stapes surgery for otosclerosis. Med J Malay 59(2):171–176 Mahfudz Z, Lokman S (2004) Outcome of stapes surgery for otosclerosis. Med J Malay 59(2):171–176
32.
go back to reference Dundar R, Bulut H, Güler OK et al (2015) Oval window temperature changes in an endoscopic stapedectomy. J Craniofac Surg 26(5):1704–1708CrossRef Dundar R, Bulut H, Güler OK et al (2015) Oval window temperature changes in an endoscopic stapedectomy. J Craniofac Surg 26(5):1704–1708CrossRef
33.
go back to reference Marchioni D, Rubini A, Gazzini L et al (2018) Complications in endoscopic ear surgery. Otol Neurotol 39(8):1012–1017CrossRef Marchioni D, Rubini A, Gazzini L et al (2018) Complications in endoscopic ear surgery. Otol Neurotol 39(8):1012–1017CrossRef
34.
go back to reference Ito T, Kubota T, Takagi A et al (2016) Safety of heat generated by endoscope light sources in simulated transcanal endoscopic ear surgery. Auris Nasus Larynx 43(5):501–506CrossRef Ito T, Kubota T, Takagi A et al (2016) Safety of heat generated by endoscope light sources in simulated transcanal endoscopic ear surgery. Auris Nasus Larynx 43(5):501–506CrossRef
35.
go back to reference Marchioni D, Soloperto D, Villari D et al (2016) Stapes malformations: the contribute of the endoscopy for diagnosis and surgery. Eur Arch Otorhinolaryngol 273(7):1723–1729CrossRef Marchioni D, Soloperto D, Villari D et al (2016) Stapes malformations: the contribute of the endoscopy for diagnosis and surgery. Eur Arch Otorhinolaryngol 273(7):1723–1729CrossRef
Metadata
Title
Endoscopic stapedotomy: safety and audiological results in 150 patients
Authors
Luca Bianconi
Luca Gazzini
Elisa Laura
Stefano De Rossi
Alessandro Conti
Daniele Marchioni
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 1/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05688-y

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