A Retrospective Analysis of Postoperative Hearing and Complications of Ttranscanal Endoscopic Stapes Surgery (Postoperative Outcomes of Endoscopic Stapes Surgery)

By June 7, 2019

Akinori, Yoshida; Tsukasa, Ito; Hirooki, Matsui; Takashi Asano; Toshinori, Kubota; Takatoshi, Furukawa; Takanari, Goto; Kazunori, Futai; Chikako, Shinkawa; Seiji, Kakehata
Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Transcanal endoscopic stapes surgery has many benefits including good visualization, easy access to the stapes, and less invasiveness compared with microscopic ear surgery. We investigated the postoperative outcomes of patients who underwent endoscopic stapes surgery.

Study Design: Retrospective analysis.
Setting: University hospital.
Patients: Thirty-eight patients who underwent endoscopic stapes surgery between January 2012 and December 2017. Thirty-four patients were treated for otosclerosis, 2 patients for a stapes fixation due to chronic otitis media, 2 patients for stapes malformation. The mean age of patients was 50.6 years (18-79) and mean follow-up duration was 28 months (12–60).
Intervention: Transcanal endoscopic stapes surgery (Fisch’s reversal steps stapedotomy).

Main Outcome Measures: Pure tone audiometry was carried out for all patients pre- and postoperatively. Air conduction and bone conduction thresholds were measured at frequencies of 500, 1000, 2000, and 3000 (average of 2000 and 4000) in accordance with the criteria of the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS). Postoperative complications were investigated retrospectively based on medical records.

Results: The postoperative air-bone gap closed to less than 10 dB in 31 (81.6%) patients which is considered successful based on the AAO-HNS criteria. Complications included 11 patients (28.9%) with vertigo or dizziness, 7 patients (18.4%) with tinnitus, and 4 patients (10.5%) with dysgeusia despite no incidence of intraoperative severing of the chorda tympani. In contrast, no patients experienced sensorineural hearing loss or facial nerve palsy.

Endoscopic stapes surgery with Fisch’s reversal steps procedure can be safely employed for stapes surgery to successfully treat an array of conditions.