Huang, David Chang-Wei1
1 Department of Otolaryngology – Head and Neck Surgery, Kuang-Tien General Hospital, Taiwan
Narrow external auditory was popular in asian people. It enhance the difficulty to perform EES stapes surgey. So it was important to point out and share some tips in EES stapes surgery for asian patients.
-Patients: from 2015.07 to 2018.07, we enrolled 80 stapes surgery cases including 62 otosclerosis and 18 congenital middle ear anomaly.
-Intervention: EES exploratory tympanotomy and ossiculoplasty with TORP or piston.
-Main Outcome Measures: operation postures, footplate color, stapedotomy instruments(skeeter or laser or manual perforator), scope holder usage, and anesthesia type(Sevo or TIVA) are taken into consideration.
-Results: Standing posture may add 20-degree in average of stapes visual field and decrease 40% normal scutum and posterior EAC bone sacrifice. There are 84% blue and 16% white for otosclerotic footplate color. The entity of white and blue otosclerosis were quite different from western people. So CO2 laser is the best choice. We introduced 2-surgeon-4-hand(with assistant) and chopstick technique(without assistant) for piston crimping. TIVA was not suitable for stapes surgery owing to occasional dangerous bucking condition.
-Conclusion: We offer Taiwan’s experience in the tips of EES stapes surgery for narrowed external auditory meatus asian people including standing posture, chopstick technique, and the pathological difference from western otosclerosis.