Search

Abstract Background The traditional approach for viewing middle ear structures during ear surgery is still the microscope, which provides both hands’ flexibility and binocular vision. The requirement for a clear, direct vision of the working zone is its primary disadvantage. The procedure was modified for the microscope by using an end-aural approach, drilling the bone canal, and then moving the patient and surgeon. However, the microscope has successfully demonstrated that it is the preferred tool for stapedectomy. Objective To compare endoscopic and microscopic interventions in stapes surgery regarding intraoperative and postoperative outcomes. Patients and methods The review was a meta-analytic and systematic review that included randomized controlled trials (RCT), case series, and retrospective studies which studied the comparison of microscopic and endoscopic stapes surgery; 15 articles published between 2014 and 2020 were included in our study. Data sources PubMed, Embase, and Cochrane Library were searched for studies published up to 2020. The inclusion criteria comprised randomized controlled trials, cohort studies, and case–control studies comparing microscopic and endoscopic stapes surgeries. Results Our results showed that the injury to the chorda tympani nerve was significantly higher in the microscopic group versus the endoscopic group. And also, as regards the operative times, it was significantly longer in the microscopic group versus the endoscopic group. But there is no significant difference as regards pain, dizziness, perforation of the tympanic membrane, delayed conductive hearing and postoperative air–bone gap improvement, and taste disturbance between both groups. Conclusion Technologically, safely, and promisingly, endoscopic stapes procedures are possible. All things considered, our research shows that both microscopic and endoscopic stapes surgery yields good audiological outcomes. A little amount of data, however, points to a decreased likelihood of chorda tympani injury and taste disturbance when using an endoscope. With comparable side effects to microscopic stapes surgery (pain, tympanic membrane perforation, taste disturbance, dizziness, and delayed conductive hearing), endoscopic stapes surgery seems like a feasible substitute. Endoscopic stapes surgery was found to need shorter operating times. In comparison to endoscopic groups, the postoperative air–bone gap increased considerably in the microscopic group. All of the studies consistently indicated better sight with the endoscope. This meta-analysis of the available data bolsters the application of endoscopic methods in stapes surgery.

Abstract Background Endoscopic ear surgery is a new, less invasive otologic procedure. Since 1990s, it has been grown in prominence because of anatomical and physiological theories. It offers a view of hidden places, avoids mastoidectomies and endaural vertical and postauricular incisions, and has many other benefits over microscopic surgery. The purpose of this study was to distinguish the difference between the outcomes of microscopic and endoscopic cholesteatoma surgery. Methods Eighty individuals who were diagnosed with cholesteatoma participated in this randomized clinical research. Patients were randomly allocated into two equivalent treatment groups. One group submitted to tympanoplasty via microscopic ear surgery and the other group had exclusive trans-canal endoscopic ear surgery. All patients had preoperative otomicroscopic and radiologic assessment to ensure cholesteatoma diagnosis. Audiological evaluations were also obtained. Results There was no discernible difference in the tested groups’ operational times, air-bone gaps, or air conduction. The endoscopic surgery group healed significantly more quickly than the microscopic surgery group (5.4 0.5 vs 7.7 0.5 weeks, p > 0.001). The frequency of residual lesions (5.0% vs 22.5%, p = 0.023) and recurrence (7.5% vs 27.5%, p = 0.019) was significantly lower in the endoscopic group of patients. Conclusions When comparing healing times, rates of residual disease and rates of recurrence, endoscopic surgery clearly outperforms microscopic surgery. The endoscope encourages visualization and magnification of anatomy while being less invasive thanks to its improved picture quality, lighting, and capacity to “see around the corner.” Additionally, a significant portion of viable mastoid tissues and healthy mucosa were preserved.

Abstract Aim and background Intranasal transsphenoidal access to the sella turcica for removing pituitary gland tumors has been known since the beginning of the last century. It can be done either endoscopic or microscopic. Postoperative nasal complications may happen. The purpose of this study was to assess the frequency of chronic oronasal alterations. Methodology 33 patients who had previously undergone adenomectomy with a hypophyseal transsphenoidal approach using either the endoscopic or the direct transnasal microscopic technique; these patients were operated in different neurosurgical units. Assessement of nasal complications after 6 months was done. Results 33 patients among them 18 patients were done by endoscopy and the other 15 were done by microscopy. No postoperative nasal complications in the endoscopy group 6 months postoperative while it is present in 3 cases of the microscopic group after the same time. Conclusion Direct transnasal approach provides safe transsphenoidal access to the sella with a very low rate of nasal complications.