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Comparison of endoscopic and microscopic stapedotomy in the same patients: a prospective randomized controlled trial

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to conduct a comparative analysis of audiological and postoperative clinical outcomes between the endoscopic and microscopic stapedotomy approaches.

Methods

This study employed a randomized, controlled design. Twenty-seven patients with bilateral otosclerosis underwent stapedotomy in both ears, with randomized allocation of the surgical technique (endoscopic vs. microscopic) for the first operated ear. Air-bone gap (ABG) and ABG gain were measured at least 12 months postoperatively. Postoperative outcomes including pain (Visual Analog Scale-VAS), dizziness, early-term (day 1) and late-term (6 months) dysgeusia were evaluated. The Glasgow Benefit Inventory (GBI) assessed health-related quality of life at one month postoperatively, and operative time was measured.

Results

This study compared endoscopic (n = 27 ears) and microscopic (n = 27 ears) stapedotomy for otosclerosis. Both groups achieved similar hearing improvement with no significant differences in pre-operative and post-operative bone/air conduction thresholds, ABG, and ABG gain (all p > 0.05). The endoscopic stapedotomy group demonstrated reduced postoperative pain (lower VAS scores, p < 0.001), lower early dysgeusia (3.7% vs. 33.3%, p = 0.005), shorter operative time (47.3 vs. 75.4 min, p < 0.001) and improved patient-reported outcomes (higher GBI score, p = 0.014) when compared to microscopic stapedotomy group. No significant differences were observed in postoperative dizziness or late-term dysgeusia between groups.

Conclusion

This study found similar hearing improvement with both endoscopic and microscopic stapedotomy for otosclerosis. However, the endoscopic approach showed advantages in reduced postoperative pain, early dysgeusia, and operative time, with improved patient-reported quality of life. These findings suggest endoscopic stapedotomy as a valuable alternative to the conventional microscopic approach.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Ege University Faculty of Medicine, Izmir, Turkey

    İsa Kaya, Süleyman Eroğlu & Tayfun Kirazli

  2. Department of Otorhinolaryngology, Kızıltepe State Hospital, Mardin, Turkey

    Fetih Furkan Şahin

  3. Department of Otorhinolaryngology, Şırnak State Hospital, Şırnak, Turkey

    Hasan Tanrıverdi

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  1. İsa Kaya
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Corresponding author

Correspondence to Fetih Furkan Şahin.

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The ethics committee approval was received for this study (Approval number: 20-11.1T/12).

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Written informed consent was obtained from patients who participated in this study.

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The authors declared that this study received no financial support.

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Kaya, İ., Şahin, F.F., Tanrıverdi, H. et al. Comparison of endoscopic and microscopic stapedotomy in the same patients: a prospective randomized controlled trial. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08823-6

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