Pediatric Stapes Surgery: Hearing and Surgical Outcomes in Endoscopic vs Microscopic Approaches

• Published in: Otolaryngology-head and neck surgery Vol. 161; no. 1; p. 150
• Main Authors: Tolisano, Anthony M, Fontenot, Miles R, Nassiri, Ashley M, Hunter, Jacob B, Kutz, Jr, Joe Walter, Rivas, Alejandro, Isaacson, Brandon
• Format: Journal Article
• Language: English
• Published: England 01.07.2019
• Subjects: Adolescent; Child; Endoscopy - methods; Female; Hearing Tests; Humans; Male; Microsurgery - methods; Otosclerosis - surgery; Stapes - abnormalities; Stapes Surgery - methods; endoscopic ear surgery; children; stapedotomy; stapes mobilization; hearing loss; pediatric; stapedectomy
• ISSN: 1097-6817
• DOI: 10.1177/0194599819836679

To compare endoscopic and microscopic pediatric stapes surgery. Case series with chart review. Two academic otology practices. Surgical and hearing outcomes were compared for consecutive children (<18 years) undergoing microscopic and endoscopic stapes surgery. The main outcome measure was closure of the air-bone gap (ABG) to ≤20 dB. Twenty-two endoscopic surgeries (17 stapedectomies, 4 stapedotomies, and 1 stapes mobilization) and 52 microscopic surgeries (30 stapedectomies, 19 stapedotomies, and 3 stapes mobilizations) were performed. Patient demographics, history of ipsilateral middle ear surgery, and revision stapes surgery status were similar. The most common diagnosis for the endoscopic group and microscopic group were congenital stapes footplate fixation (45.5%) and juvenile otosclerosis (46.2%), respectively. Preoperative ABGs in the endoscopic (37.7 dB) and microscopic (32.8 dB) groups ( = .170) were similar. There were no major complications, including facial nerve injury or anacusis, in the endoscopic group. Postoperative sensorineural hearing loss (>15 dB) did not occur in any patients in the endoscopic group but was present in 2 patients in the microscopic group ( = .546). Improvement in pure-tone average (25.9 dB vs 18.5 dB, = .382) and ABG (21.7 dB vs 14.7 dB, = .181) was similar, and postoperatively, the median ABG was 11.3 dB and 15.0 dB for endoscopic and microscopic cases ( = .703), respectively. ABG closure to ≤20 dB (72.7% vs 65.2%, = .591) was also similar. Pediatric endoscopic stapes surgery is safe and hearing outcomes are similar to the microscopic approach when performed by experienced endoscopic ear surgeons.