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ORIGINAL ARTICLE
Year : 2017  |  Volume : 33  |  Issue : 2  |  Page : 477-483

Transcanal totally endoscopic stapes surgery: step-by-step procedure


Department of Otorhinolaryngology, Faculty of Medicine; Departement of Otorhinolaryngology H&N Surgery, Alexandria Faculty of Medicine, Alexandria, Egypt

Correspondence Address:
Ahmed A Omran
Department of Otorhinolaryngology, Faculty of Medicine, University of Alexandria, 57 Safia Zaghloul Street, El Ramel Station, Alexandria 21521
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1012-5574.206014

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Objectives The purpose of the present work was to evaluate the role of otoendoscopy in performing stapedotomy in clinically otosclerotic patients. Patients and methods Twenty patients presenting with clinically diagnosed otosclerosis were randomly selected from the outpatient ENT clinic in a tertiary referral Institutional Hospital. All patients were subjected to transcanal totally endoscopic stapes surgery (TTESS) from early 2013 to the fall of 2014. Methods This prospective study demonstrated the detailed technique of TTESS using mainly 0° lens of 14 cm length rigid endoscope for elevating the tympanomeatal flap, handling the chorda tympani nerve, curettage of posterior bony canal wall, visualization of oval window niche structures, creation of stapedotomy, and accurate prosthesis insertion. Postoperative audiogram was performed after 2 months. Assessment of postoperative complications, especially change in taste sensation, was carried out. Results The chorda tympani nerve was preserved in all cases. Two cases had change in taste sensation that was improved within 6 months postoperatively. There was a significant improvement in hearing. The preoperative air-bone gap mean value was 40.30±6.38, and the postoperative mean value was 7.15±4.27 (P=0.001), with complete closure of air-bone gap in four cases. No facial paralysis or tympanic membrane perforation was encountered during the follow-up period. Conclusion Transcanal totally endoscopic stapes surgery is a feasible and safe technique for the surgical management of conductive hearing loss associated with otosclerosis, which is recommended in bilateral and revision cases.


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