Endoscopic transcanal management of tympanosclerosis.
Endoscopic tympanoplasty
Malleostapediopexy
Stapes fixation
Tympanosclerosis
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
22
11
2020
accepted:
08
02
2021
pubmed:
21
2
2021
medline:
1
2
2022
entrez:
20
2
2021
Statut:
ppublish
Résumé
The objectives of this study are to describe our experiences in endoscopic transcanal management of tympanosclerosis, to explain our surgical approaches to reconstruct the sound conduction system and to analyze the hearing results obtained with our surgical approaches. A retrospective cohort study, using medical records of 28 cases that underwent endoscopic transcanal tympanoplasty surgery due to tympanosclerosis from January 2016 to January 2020. Private otology clinic PATIENTS: Twenty-eight ears of 26 patients were enrolled into study. Patients were grouped according to Wielinga-Kerr classification and only type II, III and IV patients were included in the study. Exclusively transcanal endoscopic surgery was performed in all cases. Primary goal was to mobilize the affected ossicles by removing the offending TS and reconstruct the ossicular chain. Malleostapediopexy was preferred when attic by-pass procedures were needed. Glass ionemer bone cement was used to reconstruct the ossicular defects. Preoperative and postoperative pure tone average of air conduction and bone conduction and air-bone gap results were evaluated. Operation was considered successful if postoperative ABG < 20 dB was achieved. Complications and graft take rate were also evaluated. Single-staged surgery was performed in 23 of 28 cases (82.1%). Graft take rate was 93%. The mean preoperative ABG significantly decreased from 33.9 ± 5.19 to 12.55 ± 5.52 dB postoperatively for 23 cases who had single-staged surgeries (p < 0.001, Wilcoxon signed rank test) at the end of the mean follow-up period of 23 months. For this group, the mean preoperative AC-PTA significantly improved from 48.64 ± 9.30 to 22.93 ± 7.45 dB (p < 0.001, Wilcoxon signed rank test) postoperatively with a mean PTA improvement of 25.71 ± 6.02 dB. Success criterion was achieved in 22 of 23 cases (95.7%). There was no sensorineural hearing loss, facial nerve paralysis and postoperative vertigo after the surgical procedures. All patients had been discharged within the first 24 h. Surgical treatment of tympanosclerosis is still a controversial issue. Endoscopic surgery seems a safe technique for the management of tympanosclerosis. Single-stage surgery is possible in most of the cases with a satisfactory hearing result. We speculate that addition of endoscopic view may increase the single-stage surgery ratio.
Identifiants
pubmed: 33609176
doi: 10.1007/s00405-021-06692-x
pii: 10.1007/s00405-021-06692-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
677-683Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
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