Endoscopic Versus Microscopic Approaches for Stapes Surgery

By June 7, 2019

Pauna, Henrique1; Pereira, Renato2; Monsanto, Rafael3; Hyppolito, Miguel1
1 Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School / University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
2 Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
3 Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, São Paulo, Brazil

To evaluate the surgical techniques, approaches, audiologic outcomes, and complications of endoscopic stapes surgery compared to conventional microscopic approach.

Data sources: We performed systematic searches of the literature in the PubMed, Web of Science and Scopus databases, from  July 2017 to February 2018.
Study selection: We included studies involving patients subjected to stapes surgery using endoscopic approaches and studies reporting objective post-operative hearing outcomes.
Data extraction: From the articles we extracted the following information: surgical time; complications; surgical technique; and audiometric results.

Data synthesis:
We selelected 14 studies for appraisal. The selected studies included a total of 282 ears subjected to endoscopic stapes surgery. Generally, endoscopic stapes surgery seems to provide better visualization of the middle ear structures, therefore allowing less traumatic and invasive surgery and potentially better audiologic outcomes as compared with the conventional approach. Other advantages of endoscopic stapes surgery include less surgery time, less need for drilling, and auditory results comparable to the conventional techniques. Over 80% of patients subjected to endoscopic stapedectomy had post-operative air-bone gaps of less than 10dB.

Studies have shown that endoscopic stapes surgery has potential surgical and functional advantages as compared with microscopic surgery.