Sproat Rhona, Yiannakis Constantina, Iyer Arunachalam
Department of Otolaryngology, Monklands Hospital, Airdrie, Scotland, UK.
Otol Neurotol. 2017 Jun;38(5):662-666. doi: 10.1097/MAO.0000000000001371.
To investigate postoperative audiological outcomes and complication rates for fully endoscopic and microscopic stapes surgery carried out by a single surgeon in one center.
All patients having undergone endoscopic and non-endoscopic stapes surgery for otosclerosis from September 2009 to August 2016 under a single surgeon.
INTERVENTION(S): Stapedotomy using either an operating microscope or endoscope for visualization. Stapedotomy was carried out using a standard approach.
MAIN OUTCOME MEASURE(S): Pre- and postoperative audiometry and complications.
Thirty-four patients who underwent endoscopic stapes surgery and 47 patients who underwent non-endoscopic stapes surgery were included in this study. Seventy-nine percent of both endoscopic and non-endoscopic groups had the average air-bone gap closed to less than 10 dBHL, respectively; the difference was not significant (p = 0.940, χ test). No patients with sensorineural hearing loss, vertigo, or facial nerve paresis were reported. Two of 34 patients (6%) of the endoscopic group had the chorda tympani cut intraoperatively for access compared with 11 of 47 patients (23%) of the non-endoscopic group. Sixteen of 47 patients (34%) required an endaural incision for access in the non-endoscopic group; no endaural incisions were made in the endoscopic group.
Air-bone gap closure and patient complications did not vary significantly between endoscopic and non-endoscopic groups in this study of 34 endoscopic procedures. There is a requirement for further studies with larger sample sizes and longer follow-up periods to fully gauge the safety and effectiveness of this technique.
调查由一名外科医生在一个中心进行的全内镜和显微镜下镫骨手术的术后听力学结果及并发症发生率。
2009年9月至2016年8月间，在同一名外科医生处接受内镜和非内镜镫骨手术治疗耳硬化症的所有患者。
使用手术显微镜或内镜进行可视化的镫骨切除术。采用标准方法进行镫骨切除术。
术前和术后听力测定及并发症。
本研究纳入了34例行内镜镫骨手术的患者和47例行非内镜镫骨手术的患者。内镜组和非内镜组分别有79%的患者平均气骨导差缩小至小于10 dBHL；差异无统计学意义（p = 0.940，χ检验）。未报告有感音神经性听力损失、眩晕或面神经麻痹的患者。内镜组34例患者中有2例（6%）术中为便于操作切断了鼓索神经，而非内镜组47例患者中有11例（23%）。非内镜组47例患者中有16例（34%）需要耳内切口以便操作；内镜组未做耳内切口。
在这项34例内镜手术的研究中，内镜组和非内镜组在气骨导差缩小及患者并发症方面无显著差异。需要进一步开展样本量更大、随访期更长的研究，以全面评估该技术的安全性和有效性。
