{Reference Type}: Journal Article
{Title}: Comparison of endoscopic vs microscopic ossiculoplasty: a study of 157 consecutive cases.
{Author}: Coleman H;Tikka T;Curran J;Iyer A;
{Journal}: Eur Arch Otorhinolaryngol
{Volume}: 280
{Issue}: 1
{Year}: Jan 2023
{Factor}: 3.236
{DOI}: 10.1007/s00405-022-07451-2
{Abstract}: <B>OBJECTIVE: </B>The relatively new technique of trans-canal endoscopic ear surgery (TEES) when compared to microsurgery for ossiculoplasty has advantages of better visualization and no external incision but also has the disadvantage of being a one-handed procedure. Our study aimed to compare audiometric outcomes following ossiculoplasty performed via TESS with results of microsurgery.<BR><B>METHODS: </B>Data from a prospective audit of 157 consecutive patients who underwent ossiculoplasty by a single otologist from 2009 to 2018 was analyzed. TEES was introduced in the department in 2014; therefore, all patients before this period underwent microsurgery. Patients were classified by surgical approach, TEES, or microsurgery. Audiological outcomes were recorded at 3 and 12 months postoperatively and compared to pre-operative levels. Other variables included were the condition of stapes and reconstruction material used.<BR><B>RESULTS: </B>Of the 157 cases, 50 were TEES and 107 were microsurgery (81 microscope only and 27 combined with endoscope). There was statistically significant improvement (p < 0.001) in AC (43.4 dB pre-operatively, 36.2 dB postoperatively), BC (20.3 dB pre-operatively, 17.6 dB postoperatively), and ABG (21.8 dB pre-operatively, 16.7 dB postoperatively) in the total cohort. Both groups achieved an ABG better than 20 dB; 72% in TEES, 73% in the microscopic group, and there was no significant difference. There was no change in hearing at 12 months when compared to 3 months. No statistically significant difference was noted based on stapes condition, type of material used for ossiculoplasty, or tympanic membrane graft.<BR><B>CONCLUSIONS: </B>TEES is safe and as effective as microsurgery in ossiculoplasty with possibly much less pain and morbidity.<BR><B>METHODS: </B>