To Evaluate the Postoperative Outcomes of the Endoscopic StepsQ5 surgery Performed in a Single Tertiary Care Center
30 September 2019 (online)
Objective To evaluate the postoperative outcomes of the endoscopic stapes surgery performed in a single tertiary care center.
Materials and Methods Retrospective case series contained 32 ears of stapedial otosclerosis, conducted in the department of ENT and Head–Neck Surgery, AIIMS, Bhubaneswar, from May 2016 to December 1017. All the patients had undergone endoscopic stapes surgery for otosclerosis using the standard endoscopic approach. Lobular fat had been utilized for plugging of the stapedotomy hole in all the cases. Anatomical functional outcomes were analyzed after 1, 4, and 6 weeks in the postoperative period.
Results Twenty-six patients were included (90% women) with a median age of 32.6 years (range, 23–49 years). The median follow-up was 5.3 months (range, 3–12 months). The chorda tympani nerve was sacrificed in 8.4% cases. Postoperative disequilibrium was detected in 7.0% cases and 100% resolution at first follow-up. The median air-bone gap (ABG) improved from 30.3 dB preoperatively to 9.35 dB postoperatively at last follow-up (p < 0.0001). The ABG closed to less than 15dB in 89.3% of patients and less than 10 dB in 79%. There were no instances of postoperative sensorineural hearing loss (defined as > 15 dB change from baseline) or facial nerve injury. Postoperatively, 29.6% of patients reported dysgeusia, of which 8.3% were persistent at last follow-up.
Conclusion Endoscopic stapedotomy is an effective technique to manage stapes fixation resulting in a median postoperative ABG of 9.35 dB and ABG closure to within 10dB in 79% of patients. Autologous lobular fat can be effectively used in controlling the disequilibrium in the immediate postoperative period.