Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure

Introduction Endoscopes are not only complementing microscopic ear surgery but are also establishing their independent role in recent years. Materials and Methods This observational study was conducted from February 2018 to February 2019. Thirteen patients with clinical and audio-tympanometric fe...

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Main Authors: Bhaskar Ghosh, Bijan Kumar Adhikary
Format: Article
Language:English
Published: The Association of Otolaryngologists of India, West Bengal 2019-08-01
Series:Bengal Journal of Otolaryngology and Head Neck Surgery
Subjects:
Online Access:https://bjohns.in/journal/index.php/bjohns/article/view/543
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author Bhaskar Ghosh
Bijan Kumar Adhikary
author_facet Bhaskar Ghosh
Bijan Kumar Adhikary
author_sort Bhaskar Ghosh
collection DOAJ
description Introduction Endoscopes are not only complementing microscopic ear surgery but are also establishing their independent role in recent years. Materials and Methods This observational study was conducted from February 2018 to February 2019. Thirteen patients with clinical and audio-tympanometric features suggestive of stapedial otosclerosis underwent unilateral endoscopic stapedotomy from February to July 2018. They were followed up for a minimum of 6 months, till February 2019. Zero degree naso-endoscopes were exclusively used. Details of the surgical technique, its usefulness and subjective drawbacks are described. Results Two patients with sequel of otitis media with effusion evident at surgery were excluded. With a female predilection, the average age of the subjects was 31 years (range: 17-56 years). Curettage of the posterosuperior wall was needed in 7 patients; significant canalplasty was performed in 2 of them where the endoscope was difficult to negotiate. The chorda tympani required mobilization in only 3 patients, including those requiring significant canalplasty. Per-operative complications included injury to the chorda, tearing of tympanomeatal flap, and instability of the long process of incus in 1 patient each. One patient was lost to follow up. Average pre-operative bone conduction was 10±5dB with an air-bone gap at 35±5dB. At 6 months follow up, air-bone gap of <10dB was achieved in 5 patients, and that at10-20dB in 4. One patient developed moderate sensorineural component. Otherwise, there was no significant complication at 6 months following surgery. Conclusion Endoscopic stapedotomy is a safe and effective approach towards stapes surgery, with better surgical field of view and minimal tissue trauma.
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spelling doaj.art-17af3eaf92a547d4b537b0c4dd0e903c2024-03-02T08:40:32ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-24072019-08-01272102106211Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic ProcedureBhaskar Ghosh0Bijan Kumar Adhikary1Medical College KolkataMedical College, KolkataIntroduction Endoscopes are not only complementing microscopic ear surgery but are also establishing their independent role in recent years. Materials and Methods This observational study was conducted from February 2018 to February 2019. Thirteen patients with clinical and audio-tympanometric features suggestive of stapedial otosclerosis underwent unilateral endoscopic stapedotomy from February to July 2018. They were followed up for a minimum of 6 months, till February 2019. Zero degree naso-endoscopes were exclusively used. Details of the surgical technique, its usefulness and subjective drawbacks are described. Results Two patients with sequel of otitis media with effusion evident at surgery were excluded. With a female predilection, the average age of the subjects was 31 years (range: 17-56 years). Curettage of the posterosuperior wall was needed in 7 patients; significant canalplasty was performed in 2 of them where the endoscope was difficult to negotiate. The chorda tympani required mobilization in only 3 patients, including those requiring significant canalplasty. Per-operative complications included injury to the chorda, tearing of tympanomeatal flap, and instability of the long process of incus in 1 patient each. One patient was lost to follow up. Average pre-operative bone conduction was 10±5dB with an air-bone gap at 35±5dB. At 6 months follow up, air-bone gap of <10dB was achieved in 5 patients, and that at10-20dB in 4. One patient developed moderate sensorineural component. Otherwise, there was no significant complication at 6 months following surgery. Conclusion Endoscopic stapedotomy is a safe and effective approach towards stapes surgery, with better surgical field of view and minimal tissue trauma.https://bjohns.in/journal/index.php/bjohns/article/view/543stapes surgeryendoscopes
spellingShingle Bhaskar Ghosh
Bijan Kumar Adhikary
Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
Bengal Journal of Otolaryngology and Head Neck Surgery
stapes surgery
endoscopes
title Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
title_full Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
title_fullStr Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
title_full_unstemmed Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
title_short Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
title_sort endoscopic stapedotomy a new dimension to the conventional microscopic procedure
topic stapes surgery
endoscopes
url https://bjohns.in/journal/index.php/bjohns/article/view/543
work_keys_str_mv AT bhaskarghosh endoscopicstapedotomyanewdimensiontotheconventionalmicroscopicprocedure
AT bijankumaradhikary endoscopicstapedotomyanewdimensiontotheconventionalmicroscopicprocedure