Gulsen Secaattin, Karatas Erkan
Dr. Secaattin Gulsen, MD. ENT Specialist Department of Otorhinolaryngology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey.
Prof. Dr. Erkan Karatas, MD. Department of Otorhinolaryngology, Inonu University Faculty of Medicine, Malatya, Turkey.
Pak J Med Sci. 2019 Sep-Oct;35(5):1387-1391. doi: 10.12669/pjms.35.5.439.
The main objectives of the present study were to compare the surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery.
Sixty-one patients who underwent the stapes surgery with the endoscopic and microscopic approach between January 2012-November 2018 were included in the study. Patients were divided into two groups as a Group-I (endoscopic) and Group-II (microscopic). The audiometric measurements, duration of surgery, intraoperative findings and complications were recorded and evaluated retrospectively.
Mean operative time for the Group-I and II was 45.1±8.4 minutes and 48.7±5.6 minutes, respectively (p>0.05). The preoperative and postoperative average air-bone gap in the Group-I was 27.8±7.2 dB and 8.7±3.4 dB and these values in Group-II were 30.2±5.1 dB and 7.4±4.8 dB, respectively (p<0.001). The requirement of chorda tympani nerve manipulation and scutum curettage were significantly less in Group-I as compared Group-II (p<0.05). Dysgeusia and postoperative pain were observed significantly higher ratios in Group-II relative to Group-I (p<0.05). There was no significant difference between endoscopic and microscopic approach in stapes surgery in terms of difficulty of prosthesis insertion (p>0.05).
Endoscopic stapes surgery provides comparable audiological outcomes, shorter operative times, fewer complications rates, and more minimally invasive surgery, relative to the microscopic approach.
本研究的主要目的是比较镫骨手术中内镜和显微镜入路的手术及听力学结果。
纳入2012年1月至2018年11月期间采用内镜和显微镜入路进行镫骨手术的61例患者。患者分为两组，即I组（内镜组）和II组（显微镜组）。回顾性记录并评估听力测量结果、手术时长、术中发现及并发症。
I组和II组的平均手术时间分别为45.1±8.4分钟和48.7±5.6分钟（p>0.05）。I组术前和术后的平均气骨导间距分别为27.8±7.2 dB和8.7±3.4 dB，II组的这些值分别为30.2±5.1 dB和7.4±4.8 dB（p<0.001）。与II组相比，I组鼓索神经操作和鼓盾刮除的需求显著更少（p<0.05）。II组味觉障碍和术后疼痛的发生率显著高于I组（p<0.05）。在镫骨手术中，内镜和显微镜入路在假体插入难度方面无显著差异（p>0.05）。
与显微镜入路相比，内镜镫骨手术在听力学结果方面相当，手术时间更短，并发症发生率更低，且手术创伤更小。
