Endoscopic versus microscopic stapes surgery

Objective: The aim of this study to compare the outcomes and complications of endoscopic stapes surgery versus microscopic stapes surgery. Methods: This study involved patients who underwent stapedotomy at the Department of Otorhinolaryngology, Faculty of Medicine, Cukurova University between January 2012 and July 2014. The patients were divided into two groups. Patients in group I were operated with endoscope and patients in group II were operated with microscope. Pure tone audiometry was carried out in all patients preoperatively. Peroperative surgical findings, complications, and duration of surgery were noted and compared between the two groups. Air conduction and bone conduction thresholds were measured at frequencies of 500, 1000, 2000, and 4000 Hz, and the mean (+/- SD) air-bone gap was noted. Results: Mean preoperative air-bone gap was 36.9 +/- 6.8 dB (23.3-50 dB) in group I and 35.1 +/- 6 dB (26.6-50 dB) in group II. Mean postoperative air-bone gap was 9.3 +/- 7.1 dB (0-30 dB) in group I and 13.5 +/- 9.7 dB (1.6-35 dB) in group II. The difference in preoperative and postoperative air-bone gap between the two groups was statistically significant (p = 0.023). Patients in group I did not complain of postoperative pain but this was felt in four patients in group II. The difference was statistically significant (p = 0.045). Conclusion: Endoscopic stapes surgery has many benefits such as good visualization, and easy accessibility to the stapes, oval window niche, and facial nerve. Removal of the scutum and manipulation of the chorda tympani nerve are less frequent with the endoscopic technique. (C) 2016 Elsevier Ireland Ltd. All rights reserved.