Endoscopic stapes surgery outcomes and complication rates: a systematic review
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REVIEW ARTICLE
Endoscopic stapes surgery outcomes and complication rates: a systematic review Ricardo Bartel1,2 · Juan Jose Sanz1 · Ignacio Clemente1 · Gabriela Simonetti1 · Guillem Viscacillas1 · Laura Palomino1 · Isabel Asarta1 · Xavier Lao1 Received: 27 July 2020 / Accepted: 16 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective These days, the gold standard procedure for otosclerosis treatment is stapes surgery. The endoscopic approach of the procedure is gaining popularity as endoscopic ear surgery develops across the globe. The main objective of this study is to gather and compile well-documented and reliable data regarding surgical outcomes for the endoscopic approach to stapes surgery up to this date. Materials and methods Publications in English were searched in the PUBMED/MEDLINE database and were systematically reviewed. A total of 16 articles were reviewed according to the inclusion criteria, obtaining a total of 573 patients managed surgically for otosclerosis, using an endoscopic approach. Data were systematically extracted and compared across variables. Results Data were obtained as follows: mean age of 43 years; female proportion of 60%; 3 mm endoscope diameter of 51%, 4 mm of 39%; titanium piston-type prostheses of 52% and Teflon of 48%; length of the prosthesis (mode) was 4.5 mm; 0.6 mm diameter of the piston of 81% and 0.4 mm of 19%; mean surgical time was 55 min. Hearing results, mean preoperative air–bone gap (ABG) 31 dB; mean postoperative ABG 9 dB; ABG improvement of 22 dB; an ABG closure rate to 20 dB or less of 92% and an ABG closure rate to 10 dB or less of 77%. Complication rates: intraoperative tympanic membrane perforation of 5%; postoperative vertigo of 11%; postoperative dysgeusia of 10%; reported a postoperative neurosensorial hearing loss of 0.2%; reported gusher phenomenon of one case (0.2%). Conclusion Endoscopic stapes surgery is completely achievable using 0º angle and 4-mm-diameter sinus surgery endoscope. Instrument availability should not be an obstacle to the development of this type of surgery in any otolaryngology department. Audiological outcomes are comparable to microscopic approaches. Keywords Endoscopic stapedotomy · Endoscopic stapes surgery · Stapes surgery · Stapedotomy review · Endoscopic ear surgery
Introduction Rosen introduced the original stapes procedure for the management of otosclerosis in 1953 [1]. Following then, other surgical methods have been described, including procedures such as lateral semicircular canal fenestration, stapedectomy, and stapedotomy. Traditionally, those surgical procedures * Ricardo Bartel [email protected] 1
Otolaryngology Department, Mutua Terrassa University Hospital, University of Barcelona, Barcelona, Spain
Otology Research Group of Young Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France
2
have been achieved with the practice of an operating microscope [1]. When contrasted with traditional microsc
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