Abstract
Transcanal endoscopic stapes surgery has many benefits, including good visualization of the stapes and easy access to it, and less invasiveness when compared to microscopic ear surgery. We investigated the postoperative outcomes of patients who underwent endoscopic stapes surgery. This study examined 25 patients who underwent endoscopic stapes surgery at the Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine between January 2012 and December 2016. The Fisch’s reversal steps stapedotomy was performed via transcanal endoscopic ear surgery (TEES) in all patients. Twenty-one patients were treated for otosclerosis, 2 for stapes fixation due to chronic otitis media, and 2 for stapes malformation. The mean age of the patients was 51.0 years (18–79 years) and the mean follow-up duration was 22 months (12–60 months). Pure tone audiometry was carried out for all patients pre- and postoperatively. Air conduction and bone conduction thresholds were measured at frequencies of 500, 1000, and 2000 Hz, in accordance with the criteria of the Japan Otological Society (JOS) (2010), and at frequencies of 500, 1000, 2000, and 3000 Hz (average of 2000 and 4000 Hz) in accordance with the criteria of the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS). Postoperative complications were investigated retrospectively based on medical records. Hearing improved postoperatively in all 25 (100%) patients, based on the JOS criteria, and the postoperative air-bone gap closed down to less than 10 dB in 22 (88.0%) patients, which is considered successful according to the AAO-HNS criteria. Complications included vertigo in 4 patients (16.0%), tinnitus in 3 patients (12.0%), and dysgeusia in 2 patients (8.0%), despite no incidence of intraoperative severing of the chorda tympani. In contrast, no patients experienced sensorineural hearing loss or facial nerve palsy. Our retrospective analysis thus revealed that TEES can be safely employed in stapes surgery to successfully treat an array of conditions.
