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

Anthony M. Tolisano, Miles R. Fontenot, Ashley M. Nassiri, Jacob Boston Hunter, Joe W Kutz, Alejandro Rivas, Brandon Isaacson

Research output: Contribution to journalArticle

Abstract

Objective: To compare endoscopic and microscopic pediatric stapes surgery. Study Design: Case series with chart review. Setting: Two academic otology practices. Subjects and Methods: 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. Results: 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 (P =.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 (P =.546). Improvement in pure-tone average (25.9 dB vs 18.5 dB, P =.382) and ABG (21.7 dB vs 14.7 dB, P =.181) was similar, and postoperatively, the median ABG was 11.3 dB and 15.0 dB for endoscopic and microscopic cases (P =.703), respectively. ABG closure to ≤20 dB (72.7% vs 65.2%, P =.591) was also similar. Conclusion: Pediatric endoscopic stapes surgery is safe and hearing outcomes are similar to the microscopic approach when performed by experienced endoscopic ear surgeons.

Original languageEnglish (US)
JournalOtolaryngology - Head and Neck Surgery (United States)
DOIs
StatePublished - Jan 1 2019

Fingerprint

Stapes Surgery
Hearing
Pediatrics
Otolaryngology
Ear
Surgeons

Keywords

  • children
  • endoscopic ear surgery
  • hearing loss
  • pediatric
  • stapedectomy
  • stapedotomy
  • stapes mobilization

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Pediatric Stapes Surgery : Hearing and Surgical Outcomes in Endoscopic vs Microscopic Approaches. / Tolisano, Anthony M.; Fontenot, Miles R.; Nassiri, Ashley M.; Hunter, Jacob Boston; Kutz, Joe W; Rivas, Alejandro; Isaacson, Brandon.

In: Otolaryngology - Head and Neck Surgery (United States), 01.01.2019.

Research output: Contribution to journalArticle

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title = "Pediatric Stapes Surgery: Hearing and Surgical Outcomes in Endoscopic vs Microscopic Approaches",
abstract = "Objective: To compare endoscopic and microscopic pediatric stapes surgery. Study Design: Case series with chart review. Setting: Two academic otology practices. Subjects and Methods: 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. Results: 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 (P =.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 (P =.546). Improvement in pure-tone average (25.9 dB vs 18.5 dB, P =.382) and ABG (21.7 dB vs 14.7 dB, P =.181) was similar, and postoperatively, the median ABG was 11.3 dB and 15.0 dB for endoscopic and microscopic cases (P =.703), respectively. ABG closure to ≤20 dB (72.7{\%} vs 65.2{\%}, P =.591) was also similar. Conclusion: Pediatric endoscopic stapes surgery is safe and hearing outcomes are similar to the microscopic approach when performed by experienced endoscopic ear surgeons.",
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author = "Tolisano, {Anthony M.} and Fontenot, {Miles R.} and Nassiri, {Ashley M.} and Hunter, {Jacob Boston} and Kutz, {Joe W} and Alejandro Rivas and Brandon Isaacson",
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T2 - Hearing and Surgical Outcomes in Endoscopic vs Microscopic Approaches

AU - Tolisano, Anthony M.

AU - Fontenot, Miles R.

AU - Nassiri, Ashley M.

AU - Hunter, Jacob Boston

AU - Kutz, Joe W

AU - Rivas, Alejandro

AU - Isaacson, Brandon

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N2 - Objective: To compare endoscopic and microscopic pediatric stapes surgery. Study Design: Case series with chart review. Setting: Two academic otology practices. Subjects and Methods: 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. Results: 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 (P =.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 (P =.546). Improvement in pure-tone average (25.9 dB vs 18.5 dB, P =.382) and ABG (21.7 dB vs 14.7 dB, P =.181) was similar, and postoperatively, the median ABG was 11.3 dB and 15.0 dB for endoscopic and microscopic cases (P =.703), respectively. ABG closure to ≤20 dB (72.7% vs 65.2%, P =.591) was also similar. Conclusion: Pediatric endoscopic stapes surgery is safe and hearing outcomes are similar to the microscopic approach when performed by experienced endoscopic ear surgeons.

AB - Objective: To compare endoscopic and microscopic pediatric stapes surgery. Study Design: Case series with chart review. Setting: Two academic otology practices. Subjects and Methods: 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. Results: 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 (P =.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 (P =.546). Improvement in pure-tone average (25.9 dB vs 18.5 dB, P =.382) and ABG (21.7 dB vs 14.7 dB, P =.181) was similar, and postoperatively, the median ABG was 11.3 dB and 15.0 dB for endoscopic and microscopic cases (P =.703), respectively. ABG closure to ≤20 dB (72.7% vs 65.2%, P =.591) was also similar. Conclusion: Pediatric endoscopic stapes surgery is safe and hearing outcomes are similar to the microscopic approach when performed by experienced endoscopic ear surgeons.

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KW - stapedectomy

KW - stapedotomy

KW - stapes mobilization

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