title: Comparison between endoscopic and microscopic stapes surgery.
abstract: OBJECTIVE
  To investigate whether endoscopic stapes surgery is safer and less invasive than conventional stapes surgery using an operating microscope.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  The subjects were 15 patients (15 ears) who underwent endoscopic stapes surgery for otosclerosis or congenital stapedial fixation. Another 35 patients (41 ears) in whom microscopic stapes surgery was performed by the same surgeon were assigned to the control group. The procedures for endoscopic surgery were fundamentally the same as those for microscopic surgery, unless there was no anterior or posterior auricular skin incision. The two surgical techniques were compared with respect to the operating time, postoperative hearing, complications, postoperative pain, and the extent of drilling at the posterosuperior part of the external auditory canal.
  
  
  RESULTS
  There were no differences of operating time or postoperative hearing between the endoscopic and microscopic groups. There was very little postoperative pain in the endoscopic group. Postoperative dizziness was mild in all patients who received endoscopic surgery. Drilling at the posterosuperior part of the external auditory canal was less extensive in the endoscopic group than in the microscopic group.
  
  
  CONCLUSIONS
  Endoscopic surgery is particularly suitable for stapedial disease. Endoscopic stapes surgery can even be done in patients with a curved and narrow external auditory canal. Endoscopic surgery is also suitable for education: The surgical anatomy can be understood easily and both the surgeon and assistants can observe the procedure on the same monitor. However, it should only be performed by experienced surgeons because one-handed manipulation is required and stereoscopic vision is not available.
authors.affiliation: Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kojima
authors.forename: Manabu
authors.initials: M
authors.lastname: Komori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Chikazawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yaguchi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kyoko
authors.initials: K
authors.lastname: Chujo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*
keywords: Endoscope; microscope; otosclerosis; stapedectomy