目的:本研究的目的是对内镜下和显微镜下手术方法的听力学和术后临床结果进行比较分析。
方法:本研究采用随机,控制设计。27例双侧耳硬化症患者在双耳进行了stapedsometry切开术,随机分配手术技术(内窥镜与微观)为第一个手术的耳朵。术后至少12个月测量空气-骨间隙(ABG)和ABG增益。术后结果包括疼痛(视觉模拟量表-VAS),头晕,评估早期(第1天)和晚期(6个月)味觉障碍.格拉斯哥获益量表(GBI)评估了术后一个月与健康相关的生活质量,并测量手术时间。
结果:本研究比较了耳内镜(n=27耳)和显微镜(n=27耳)耳硬化的手术。两组均获得相似的听力改善,术前和术后骨/空气传导阈值无显着差异。ABG,和ABG增益(均p>0.05)。内镜下钳制切开术组显示术后疼痛减轻(较低的VAS评分,p<0.001),较低的早期味觉障碍(3.7%vs.33.3%,p=0.005),手术时间更短(47.3vs.75.4分钟,p<0.001)和改善患者报告的结果(更高的GBI评分,p=0.014),与显微镜下的stapedsometion组相比。两组之间在术后头晕或晚期味觉障碍方面没有显着差异。
结论:这项研究发现,耳硬化症的耳内镜和显微镜下stapedsometry手术都有相似的听力改善。然而,内镜入路在减轻术后疼痛方面显示出优势,早期的味觉障碍,和手术时间,改善患者报告的生活质量。这些发现表明,内窥镜staped切开术是传统显微镜方法的有价值的替代方法。
OBJECTIVE: This study aimed to conduct a comparative analysis of audiological and postoperative clinical outcomes between the endoscopic and microscopic stapedotomy approaches.
METHODS: This study employed a randomized, controlled design. Twenty-seven patients with bilateral
otosclerosis underwent stapedotomy in both ears, with randomized allocation of the surgical technique (endoscopic vs. microscopic) for the first operated ear. Air-bone gap (ABG) and ABG gain were measured at least 12 months postoperatively. Postoperative outcomes including pain (Visual Analog Scale-VAS), dizziness, early-term (day 1) and late-term (6 months) dysgeusia were evaluated. The Glasgow Benefit Inventory (GBI) assessed health-related quality of life at one month postoperatively, and operative time was measured.
RESULTS: This study compared endoscopic (n = 27 ears) and microscopic (n = 27 ears) stapedotomy for
otosclerosis. Both groups achieved similar hearing improvement with no significant differences in pre-operative and post-operative bone/air conduction thresholds, ABG, and ABG gain (all p > 0.05). The endoscopic stapedotomy group demonstrated reduced postoperative pain (lower VAS scores, p < 0.001), lower early dysgeusia (3.7% vs. 33.3%, p = 0.005), shorter operative time (47.3 vs. 75.4 min, p < 0.001) and improved patient-reported outcomes (higher GBI score, p = 0.014) when compared to microscopic stapedotomy group. No significant differences were observed in postoperative dizziness or late-term dysgeusia between groups.
CONCLUSIONS: This study found similar hearing improvement with both endoscopic and microscopic stapedotomy for
otosclerosis. However, the endoscopic approach showed advantages in reduced postoperative pain, early dysgeusia, and operative time, with improved patient-reported quality of life. These findings suggest endoscopic stapedotomy as a valuable alternative to the conventional microscopic approach.