Ossicular chain reconstruction: endoscopic or microscopic?

J Laryngol Otol. 2020 Dec;134(12):1108-1114. doi: 10.1017/S0022215120002728. Epub 2021 Jan 7.

Abstract

Objective: To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery.

Methods: Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air-bone gap, air-bone gap gain, word recognition score, mean operation duration and mean post-operative follow up.

Results: Post-operative air conduction, air-bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air-bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air-bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001).

Conclusion: Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Keywords: Conductive Hearing Loss; Ear Ossicles; Endoscope; Tympanoplasty.

MeSH terms

  • Adult
  • Aftercare
  • Audiometry / methods
  • Audiometry / statistics & numerical data
  • Case-Control Studies
  • Ear Ossicles / abnormalities
  • Ear Ossicles / surgery*
  • Ear, Middle / pathology
  • Ear, Middle / surgery
  • Endoscopy / methods*
  • Endoscopy / statistics & numerical data
  • Female
  • Hearing / physiology
  • Hearing Loss, Conductive / etiology
  • Hearing Loss, Conductive / surgery
  • Humans
  • Male
  • Microsurgery / methods*
  • Microsurgery / statistics & numerical data
  • Middle Aged
  • Operative Time
  • Ossicular Prosthesis / trends
  • Ossicular Replacement / methods*
  • Ossicular Replacement / trends
  • Postoperative Period
  • Retrospective Studies
  • Surgical Wound
  • Treatment Outcome