Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-05T04:14:01.374Z Has data issue: false hasContentIssue false
  • English
  • Français

Microscopic versus endoscopic stapes surgery: systematic review and meta-analysis

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  11 January 2022

J Hajiioannou Open the ORCID record for J Hajiioannou [Opens in a new window] ,
E Gkrinia Open the ORCID record for E Gkrinia [Opens in a new window] ,
K Tzimkas-Dakis ,
E Palla ,
A Brotis ,
C Korais ,
A Saratziotis ,
V Lachanas  and
C Skoulakis
J Hajiioannou*
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
E Gkrinia
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
K Tzimkas-Dakis
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
E Palla
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
A Brotis
Affiliation:
Department of Neurosurgery, University Hospital of Larissa, Larissa, Greece
C Korais
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
A Saratziotis
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
V Lachanas
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
C Skoulakis
Affiliation:
Department of ENT, University Hospital of Larissa, Larissa, Greece
*
Author for correspondence: Prof Jiannis Hajiioannou, ENT Department, Faculty of Medicine, School of Health Sciences, University of Thessaly – University Hospital of Larissa, Biopolis, 41110Larissa, Greece E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To compare the efficacy and safety characteristics of endoscopic and microscopic stapes surgery based on current evidence.

Methods

A systematic literature search was conducted of three medical databases, focusing on randomised, controlled studies or observational studies. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarised using the pooled mean differences or pooled odds ratios, along with their 95 per cent confidence intervals.

Results

Thirteen studies were included in the meta-analysis. Success rate was evaluated by estimating air–bone gap improvement; this revealed comparable outcomes for the two techniques (mean difference = −0.20; 95 per cent confidence interval = −0.53, 0.14). No statistically significant difference was detected concerning post-operative complications, except for dysgeusia (odds ratio = −1.12; 95 per cent confidence interval = −1.97, −0.28) and pain (odds ratio = −2.00; 95 per cent confidence interval = −2.97, −1.04), which favoured the endoscopic approach.

Conclusion

Though both techniques result in commensurate outcomes concerning success rate, post-operative pain and dysgeusia favour the endoscopic approach. Further high-quality studies are needed to adequately compare the two methods.

Keywords

StapesStapes SurgeryMethodsEndoscopyMicroscopyOtolaryngology
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 11 , November 2022 , pp. 1014 - 1022
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Prof J Hajiioannou takes responsibility for the integrity of the content of the paper

References

Nylean, CO. The microscope in aural surgery, its first use and later development. Acta Otolaryngol Suppl 1954;116:226–40CrossRefGoogle Scholar
Ohnsorge, P. Intraoperative middle ear endoscopy and endoscopic middle ear diagnostics with a new endoscopy unit [in German]. Arch Otorhinolaryngol 1977;216:511CrossRefGoogle Scholar
Tarabichi, M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol 1999;108:39–46CrossRefGoogle ScholarPubMed
Yong, M, Mijovic, T, Lea, J. Endoscopic ear surgery in Canada: a cross-sectional study. J Otolaryngol Head Neck Surg 2016;45:4CrossRefGoogle ScholarPubMed
Kozin, ED, Gulati, S, Lehman, A, Remenschneider, KA, Kaplan, A, Landegger, LD et al. Systematic review of endoscopic middle ear surgery outcomes. Laryngoscope 2015;125:1205–14CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med 2009;6:e1000097CrossRefGoogle ScholarPubMed
Sterne, JA, Hernán, MA, Reeves, BC, Savović, J, Berkman, ND, Viswanathan, M et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016;355:i4919CrossRefGoogle ScholarPubMed
Sterne, JAC, Savović, J, Page, MJ, Elbers, RG, Blencowe, NS, Boutron, I et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898CrossRefGoogle ScholarPubMed
GRADE Handbook. In: https://gdt.gradepro.org/app/handbook/handbook.html [28 June 2022]Google Scholar
Jamovi (Version 1.1). In: https://www.jamovi.org [11 November 2020]Google Scholar
R Core Team. R: A Language and environment for statistical computing. [Computer software]. Vienna: R Foundation for Statistical Computing, 2018Google Scholar
Kojima, H, Komori, M, Chikazawa, S, Yaguchi, Y, Yamamoto, K, Chujo, K et al. Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 2014;124:266–71CrossRefGoogle ScholarPubMed
Gulsen, S, Karatas, E. Comparison of surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery. Pak J Med Sci 2019;35:1387–91CrossRefGoogle ScholarPubMed
Daneshi, A, Jahandideh, H. Totally endoscopic stapes surgery without packing: novel technique bringing most comfort to the patients. Eur Arch Otorhinolaryngol 2016;273:631–4CrossRefGoogle ScholarPubMed
Iannella, G, Magliulo, G. Endoscopic versus microscopic approach in stapes surgery: are operative times and learning curve important for making the choice? Otol Neurotol 2016;37:1350–7CrossRefGoogle ScholarPubMed
Surmelioglu, O, Ozdemir, S, Tarkan, O, Tuncer, U, Dagkiran, M, Cetik, F. Endoscopic versus microscopic stapes surgery. Auris Nasus Larynx 2017;44:253–7CrossRefGoogle ScholarPubMed
Ardiç, FN, Aykal, K, Tümkaya, F, Kara, CO, Barlay, F. Improvement of hearing results by bone cement fixation in endoscopic stapedotomy. J Laryngol Otol 2018;132:486–8CrossRefGoogle ScholarPubMed
Bhardwaj, A, Anant, A, Bharadwaj, N, Gupta, A, Gupta, S. Stapedotomy using a 4 mm endoscope: any advantage over a microscope? J Laryngol Otol 2018;132:807–11CrossRefGoogle ScholarPubMed
Moneir, W, Abd El-Fattah, AM, Mahmoud, E, Elshaer, M. Endoscopic stapedotomy: merits and demerits. J Otol 2018;13:97–100CrossRefGoogle ScholarPubMed
Das, A, Mitra, S, Ghosh, D, Sengupta, A. Endoscopic stapedotomy: overcoming limitations of operating microscope. Ear Nose Throat J 2021;100:103–9CrossRefGoogle ScholarPubMed
Sproat, R, Yiannakis, C, Iyer, A. Endoscopic stapes surgery: a comparison with microscopic surgery. Otol Neurotol 2017;38:662–6CrossRefGoogle ScholarPubMed
Cornejo-Suarez, A, Chavez-Delgado, ME, Perez-Ramirez, R, Montoya-Hernandez, I, Montoya-Valdez, JR, Rosales-Orozco, CS et al. A modified method of local infiltration for endoscopic stapes surgery: how I do it. Eur Arch Otorhinolaryngol 2019;276:357–65CrossRefGoogle ScholarPubMed
Plodpai, Y, Atchariyasathian, V, Khaimook, W. Endoscope-assisted stapedotomy with microdrill: comparison with a conventional technique. J Med Assoc Thai 2017;100:190–6Google ScholarPubMed
Kuo, CW, Wu, HM. Fully endoscopic laser stapedotomy: is it comparable with microscopic surgery? Acta Otolaryngol 2018;138:871–6CrossRefGoogle ScholarPubMed
Quesnel, AM, Ishai, R, McKenna, MJ. Otosclerosis: temporal bone pathology. Otolaryngol Clin North Am 2018;51:291–303CrossRefGoogle ScholarPubMed
Vincent, R, Sperling, NM, Oates, J, Jindal, M. Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurotology database. Otol Neurotol 2006;27(suppl 2):S25–47CrossRefGoogle ScholarPubMed
Marchioni, D, Rubini, A, Gazzini, L, Alicandri-Ciufelli, M, Molinari, G, Reale, M et al. Complications in endoscopic ear surgery. Otol Neurotol 2018;39:1012–17CrossRefGoogle ScholarPubMed
Hall, AC, Mandavia, R, Selvadurai, D. Total endoscopic stapes surgery: systematic review and pooled analysis of audiological outcomes. Laryngoscope 2020;130:1282–6CrossRefGoogle ScholarPubMed
Nikolaos, T, Aikaterini, T, Dimitrios, D, Sarantis, B, John, G, Eleana, T et al. Does endoscopic stapedotomy increase hearing restoration rates comparing to microscopic? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2018;275:2905–13CrossRefGoogle ScholarPubMed
Koukkoullis, A, Tóth, I, Gede, N, Szakács, Z, Hegyi, P, Varga, G et al. Endoscopic versus microscopic stapes surgery outcomes: a meta-analysis and systematic review. Laryngoscope 2020;130:2019–27CrossRefGoogle ScholarPubMed
Fang, L, Xu, J, Wang, W, Huang, Y. Would endoscopic surgery be the gold standard for stapes surgery in the future? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2021;278:925–32CrossRefGoogle ScholarPubMed
Anschuetz, L, Siggemann, T, Dür, C, Dreifuss, C, Caversaccio, M, Huwendiek, S. Teaching middle ear anatomy and basic ear surgery skills: a qualitative study comparing endoscopic and microscopic techniques. Otolaryngol Head Neck Surg 2021;165:174–81CrossRefGoogle ScholarPubMed
Anschuetz, L, Stricker, D, Yacoub, A, Wimmer, W, Caversaccio, M, Huwendiek, S. Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques. BMC Med Educ 2019;19:357CrossRefGoogle ScholarPubMed
Nogueira, JF, Martins, MJB, Aguiar, CV, Pinheiro, AI. Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results. Braz J Otorhinolaryngol 2011;77:721–7Google Scholar
Aksoy, F, Dogan, R, Ozturan, O, Eren, SB, Veyseller, B, Gedik, O. Thermal effects of cold light sources used in otologic surgery. Eur Arch Otorhinolaryngol 2015;272:2679–87CrossRefGoogle ScholarPubMed
Dundar, R, Bulut, H, Güler, OK, Yükkaldiran, A, Demirtaş, Y, Iynen, I et al. Oval window temperature changes in an endoscopic stapedectomy. J Craniofac Surg 2015;26:1704–8CrossRefGoogle Scholar