Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

AbstractObjectivesTo evaluate the surgical techniques, approaches, audiological outcomes and complications of endoscopic stapes surgery.MethodsSystematic searches of the literature were performed in PubMed, Web of Science and Scopus databases, to identify studies of patients who underwent stapes surgery using endoscopic approaches and studies reporting objective post-operative hearing outcomes. The following information was extracted: surgery duration, complications, surgical technique and audiometric results.ResultsFourteen studies were selected for appraisal, which included a total of 282 ears subjected to endoscopic stapes surgery. Endoscopic stapes surgery seems to provide adequate visualisation of the middle-ear structures, thereby allowing less invasive surgery and potentially equivalent audiological outcomes as compared with a traditional microscopic approach. Other advantages of endoscopic stapes surgery include decreased surgery time, a reduced need for drilling, and auditory results comparable to those of microscopic techniques.ConclusionStudies have shown that endoscopic stapes surgery has similar surgical and functional advantages as compared with microscopic surgery.

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Trends and Profiles in Stapes Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947908800519 ◽

1979 ◽

Vol 88 (5) ◽

pp. 708-713 ◽

Cited By ~ 23

Author(s):

Richard J. Bellucci

Keyword(s):

Surgical Treatment ◽

Stapes Surgery ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Chorda Tympani ◽

Hearing Improvement ◽

Muscle Reflex

Stapedectomy has become recognized as the procedure of choice in the surgical treatment of clinical otosclerosis. Based on results obtained in stapes surgery performed in 1977, profiles were established for hearing improvement, vertigo, tinnitus, chorda tympani injury and temporary threshold shift of high tones. Tympanometric and stapedial muscle reflex tests in cases of proved clinical otosclerosis also are discussed. The profiles indicate that stapedectomy performed on a regular basis and under ideal conditions is highly successful for the improvement of hearing. The incidence and probable causes of complications are presented and discussed. This study reveals, however, that the number of new patients with otosclerosis has decreased steadily since its peak in 1964. Should the number of surgical cases continue to diminish, it may be impossible for the practicing otologist to maintain sufficient expertise for the performance of an occasional stapedectomy. Also, it may become impossible to provide sufficient experience in otosclerosis surgery for all trainees in otolaryngology.

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TOTAL ENDOSCOPIC STAPES SURGERY. OUR TECHNIQUE AND EXPERIENCE OF 45 CASES

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v1i1.7936 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S491-94

Author(s):

Muhammad Atif Najam ◽

Urwa Sarwar ◽

Maqbool Raza ◽

Khalid Azam Khan ◽

Humaira Saleem ◽

...

Keyword(s):

Facial Nerve ◽

Demographic Data ◽

Stapes Surgery ◽

Chorda Tympani ◽

Steep Learning Curve ◽

Hearing Results ◽

Stapedial Artery ◽

Ear Anomalies ◽

Postoperative Vertigo ◽

Endoscopic Stapedotomy

Objective: To assess the hearing results of transcanal endoscopic stapedotomy Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez Islamabad Pakistan, from Jun 2016 to Jun 2020. Methodology: All patients with surgically confirmed otosclerosis were included in the study. All patients were operated with 0-degree 3mm, 14cm rigid endoscope under general anesthesia. Preoperative and post operative air bone gap was noted along with demographic data, middle ear anomalies (persistent stapedial artery, dehiscent facial nerve, anteriorly placed facial nerve, floating foot plate) and injury to chorda tympani. Postoperative air bone gap (A-B Gap) was documented 12 weeks after surgery. All patients were followed up for 6-12 months Results: Mean age of patients was, 37 years and standard deviation was 12.34 (range 27-52 years). Out of total 45 cases 13 were males (29%) and 32 females (71.%). Four (8.8%) patients had dehiscent facial canal and 1 (2.2%) patient had persistent stapedial artery. Average preoperative A-B gap was 35 db and Average Postoperative A-B Gap was 7 db. Chorda tympani was preserved in all cases. One patient (2.2%) complained of altered taste which resolved after 3 months. Four patients had Postoperative vertigo that lasted 2 days on average. Conclusion: Endoscopic trans canal Stapes surgery is scarless safe effective procedure demonstrable hearing benefits in all patients with minimum complications. The Technique is single handed and has steep learning curve.

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Hydroxyapatite Prostheses in Endoscopic Transcanal Stapes Surgery for Otosclerosis Cases

Ear Nose & Throat Journal ◽

10.1177/0145561321989143 ◽

2021 ◽

pp. 014556132198914

Author(s):

Makoto Hosoya ◽

Masato Fujioka ◽

Kaoru Ogawa

Keyword(s):

Facial Nerve Palsy ◽

Case Series ◽

Ossicular Chain ◽

Tympanic Membrane Perforation ◽

Stapes Surgery ◽

Chorda Tympani ◽

Postoperative Results ◽

Ear Surgery ◽

Intraoperative Complication ◽

Membrane Perforation

Objectives: Hydroxyapatite is a commonly used material for medical applications due to its excellent biocompatibility. We use hydroxyapatite prosthesis for the reconstruction of the ossicular chain in stapes surgery. In this study, we report a case series of endoscopic ear surgery using a basket-type hydroxyapatite prosthesis. Methods: We retrospectively examined 8 cases of endoscopic transcanal stapes surgery using hydroxyapatite prostheses. We evaluated the postoperative results and complications. Results: The average postoperative air–bone gaps were within 10 dB in all cases. Postoperative sensorineural hearing loss was not observed in any case. There was an intraoperative complication with the chorda tympani in 1 patient. We were able to preserve the chorda tympani of all patients, including this case. Postoperative transient dizziness and transient taste disorder were observed in 50% of cases. No other complications, including facial nerve palsy, tympanic membrane perforation, or postoperative infection, were observed. Conclusions: The postoperative results and complications were comparable to those of surgery under a microscope. The hydroxyapatite prosthesis could be a possible alternative for the piston-type titanium or polytetrafluoroethylene prosthesis.

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Chorda tympani nerve management in endoscopic stapes surgery

Egyptian Journal of Ear Nose Throat and Allied Sciences ◽

10.1016/j.ejenta.2016.12.020 ◽

2017 ◽

Vol 18 (1) ◽

pp. 1-4

Author(s):

Ahmed Amin Omran ◽

Ahmed Aly Ibrahim ◽

Wael K.A. Hussein ◽

Yasser Osman

Keyword(s):

Stapes Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve

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Improvement of bone conduction after stapes surgery in otosclerosis patients with mixed hearing loss depending from surgical technique

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-009-0918-7 ◽

2009 ◽

Vol 266 (8) ◽

pp. 1225-1228 ◽

Cited By ~ 14

Author(s):

Alireza Karimi Yazdi ◽

Amir Arvin Sazgar ◽

Maziar Motiee ◽

Mohammadtaghi Khorsandi Ashtiani

Keyword(s):

Hearing Loss ◽

Surgical Technique ◽

Bone Conduction ◽

Stapes Surgery ◽

Mixed Hearing Loss

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Comparative study between microscopic and endoscopic stapes surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171179 ◽

2017 ◽

Vol 3 (2) ◽

pp. 285 ◽

Cited By ~ 4

Author(s):

B. Harikumar ◽

K. J. Arun Kumar

Keyword(s):

Postoperative Pain ◽

Operating Time ◽

Surgical Techniques ◽

Stapes Surgery ◽

Stereoscopic Vision ◽

Easy Access ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Microscopic Surgery ◽

Endoscopic Group

Background: To investigate whether endoscopic stapes surgery is safer and less invasive than conventional stapes surgery using an operating microscope.Methods: The subjects were 60 patients who were divided consecutively into group A undergoing microscopic stapedotomy and group B undergoing endoscopic stapedotomy. The procedures for endoscopic surgery were fundamentally the same as those for microscopic surgery, except for post aural incision used in some patients in microscopic group. The two surgical techniques were compared with respect to the operating time, approach, drilling of posterosuperior canal, manipulation of chorda tympani, visualisation of anterior crus, postoperative hearing, postoperative pain, and complications. Results: There were no differences of operating time or postoperative hearing between the endoscopic and microscopic groups. There was very little postoperative pain in the endoscopic group. Drilling at the posterosuperior part of the external auditory canal was less extensive in the endoscopic group than in the microscopic group. Visualisation of anterior crus of stapes was good in endoscopic group.Conclusions: Endoscopic stapes surgeries are technically feasible, safe and promising. The main advantages were: easy access, virtually no trauma to the chorda tympani nerve and excellent vision. The disadvantages were the lack of stereoscopic vision, having to work with one hand only and the learning curve.

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