title: Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results.
abstract: Stapedotomies are performed with the aid of surgical microscopes. However, the microscope has some limitations and may cause complications such as damage to the chorda tympani nerve. There are just a few cases and no series published on the use of sino-nasal endoscopes in stapedotomies.
  
  
  OBJECTIVE
  a) To investigate the feasibility of using sino-nasal endoscopes in stapedotomies, focusing on the visualization of important structures. b) To show initial results, discuss possible advantages and disadvantages of this instrument.
  
  
  METHODS
  15 patients with otosclerosis were selected to undergo stapedotomies in 2010. The data and surgery videos were analyzed retrospectively (study case series). The anatomical conditions of the oval window niche and surgical steps were described and used to assess possible benefits of such procedures.
  
  
  RESULTS
  The surgeries were performed with endoscopes only and all relevant anatomical structures were visualized without difficulty. No complications were observed and 14 of the 15 patients reported improvement of their hearing, confirmed by postoperative audiological tests.
  
  
  CONCLUSIONS
  Totally endoscopic stapes surgeries are technically feasible, safe and promising. In this small series, the main advantages were: virtually no trauma to the chorda tympani nerve and excellent vision. The disadvantages were the lack of stereoscopic vision, having to work with one hand only and the learning curve.
authors.affiliation: Hospital Geral de Fortaleza, Instituto de Otorrinolaringologia e Oftalmologia de Fortaleza.
authors.forename: João Flávio
authors.initials: JF
authors.lastname: Nogueira Júnior
authors.forename: Marcos Jullian Barreto
authors.initials: MJ
authors.lastname: Martins
authors.forename: Carolina Veras
authors.initials: CV
authors.lastname: Aguiar
authors.forename: Antônio Israel
authors.initials: AI
authors.lastname: Pinheiro
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D010040:Otosclerosis / Q000601:surgery*; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome