Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
Laryngoscope. 2021 Apr;131(4):885-891. doi: 10.1002/lary.28943. Epub 2020 Aug 15.
OBJECTIVES/HYPOTHESIS: To assess hearing outcomes and complications of endoscopic stapes surgery by a single surgeon in a 10-year period, to compare these data with conventional microscopic procedures by the same operator, and to describe the learning curve of endoscopic stapedotomy.
Retrospective study.
This is a retrospective study on patients who underwent endoscopic stapes surgery performed by the same senior surgeon, experienced both in microscopic and endoscopic techniques, between January 2009 and December 2018. Audiological data were compared, and intraoperative and postoperative complications were collected. The surgeon's last 30 cases of microscopic stapedotomy were enrolled as the control group. The results of the first 100 endoscopic stapes surgeries were analyzed separately to create a cumulative sum (CUSUM) control chart for learning curve assessment.
One hundred seventy-eight endoscopic and 30 microscopic stapes surgeries were included. In the endoscopic group, the mean postoperative air-bone gap was 8.2 dB. No significant differences between the endoscopic and microscopic preoperative and postoperative values were reported. A total of eight complications (4.5%) were observed in the endoscopic cohort, although in the control group, no complication occurred. The mean surgical time was 51.9 minutes in the endoscopic group versus 48.2 minutes in the microscopic group (P > .05). No association between stapedotomy success and the increasing number of procedures was found.
Our article demonstrates that functional results from endoscopic stapes surgery are similar to those from microscopic stapes surgery in terms of both safety and efficacy. After gaining endoscopic experience, the surgical duration of stapes surgery will be adequate starting from the first cases.
4 Laryngoscope, 131:885-891, 2021.
目的/假设：评估一位外科医生在 10 年内进行内镜镫骨手术的听力结果和并发症，将这些数据与同一术者的传统显微镜手术进行比较，并描述内镜镫骨切开术的学习曲线。
回顾性研究。
这是一项回顾性研究，纳入了 2009 年 1 月至 2018 年 12 月期间由同一位经验丰富的外科医生（在显微镜和内镜技术方面均有经验）进行的内镜镫骨手术患者。比较了听力数据，并收集了术中及术后并发症。还纳入了外科医生最后 30 例显微镜镫骨切开术作为对照组。单独分析了前 100 例内镜镫骨手术的结果，以创建学习曲线评估的累积和（CUSUM）控制图。
共纳入 178 例内镜和 30 例显微镜镫骨手术。在内镜组中，术后平均气骨导差为 8.2dB。未报告内镜组术前和术后值与显微镜组之间有显著差异。内镜组共观察到 8 例并发症（4.5%），而对照组无并发症发生。内镜组的平均手术时间为 51.9 分钟，而显微镜组为 48.2 分钟（P >.05）。未发现镫骨切开术成功率与手术次数增加之间存在关联。
我们的文章表明，在内窥镜和显微镜镫骨手术的安全性和有效性方面，内镜镫骨手术的功能结果相似。在获得内镜经验后，从第一例手术开始，镫骨手术的手术时间将足够。
4 Laryngoscope, 131:885-891, 2021.
