Primary Endoscopic Stapes Surgery: A Comparison of Adipose Tissue and Gelfoam Seal
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ORIGINAL ARTICLE
Primary Endoscopic Stapes Surgery: A Comparison of Adipose Tissue and Gelfoam Seal Pradeep Pradhan1 • Anindya Nayak1 • Sidharth Pradhan1 • Prity Sharma1 Chappity Preetam1 • Pradipta Kumar Parida1
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Received: 3 August 2020 / Accepted: 5 October 2020 Ó The Author(s) 2020
Abstract To compare the efficacy between the commonly used sealing materials, i.e., adipose tissue and the gelfoam in primary endoscopic stapedotomy. Lobular fat and gelfoam have been used in patients who underwent endoscopic stapedotomy between two groups, each containing 29 patients. The hearing outcomes and postoperative complications were compared at the end of 12 weeks between two groups. The ABG of B 10 dB was achieved in 69% of cases in group A and 76% of cases in group B. There was a significant short-term (1 week) improvement in the Dizziness Handicap Inventory score (p = 00) with patients of adipose tissue seal compared to the gelfoam. Although the audiological outcomes were comparable between the two groups, the use of the adipose tissue can be a better alternative than gelfoam to control vertigo in the early postoperative period without causing any significant morbidity to the patient. Keywords Endoscopic stapes surgery Adipose tissue seal Gelfoam seal Comparison
Introduction Because of the enhanced visualization of the middle ear, endoscopic stapedotomy has become more popular in recent times. It ensures the preservation of the posterior canal wall along with the chorda tympani nerve in the
& Pradeep Pradhan [email protected] 1
Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha 751019, India
majority of cases [1–3]. The improved visual field could have been possible due to the advancement of the rigid endoscopes for the inspection of the detailed middle ear structures far away from the surgical field [4, 5]. Although satisfactory clinical and audiological results have been obtained in endoscopic stapes surgery as reported in the literature [6], the vestibular dysfunction (giddiness) in the postoperative period is rarely described. Various autologous and synthetic materials have been used in the past to seal the oval window to overcome the commonest complication, i.e., giddiness resulted in inconsistent control over vertigo in spite of similar hearing outcomes [7, 8]. Amongst all, gelfoam and fat are common sealing materials used for the closure of the stapes fenestra irrespective of the surgical techniques. Autologous fat, because of its better sealing properties, could be more effective in controlling postoperative vertigo besides significant improvement in hearing [8]. In the present study, we have compared the efficacy between the commonly used sealing materials, i.e., adipose tissue and the gelfoam, with concern to the audiological and vestibular outcome in the postoperative period in patients undergoing primary endoscopic stapes surgery.
Materials and Methods This was a retrospective study of patients who were operated in the Department o
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