Two-handed endoscopic ear surgery: Feasibility for stapes surgery.

ABSTRACT

OBJECTIVE: Endoscopic ear surgery is becoming an increasingly popular approach. Our aim in this study is to evaluate the feasibility of the two-handed endoscopic technique for stapes surgery, which has its own unique steps. METHODS: Patients who underwent two-handed endoscopic stapes surgery between September 2017 and February 2018 were included in this study. Preoperative and postoperative pure tone averages and air bone gaps, intraoperative complications were recorded. All procedures were performed under hypotensive general anesthesia by the same surgeon using 0° rigid endoscopes of 2.7-mm diameter, 14-cm length with an endoscope holder. RESULTS: Seven endoscopic two-handed stapes surgery were performed between September 2017 and February 2018. Of these, six patients were operated entirely endoscopically because one patient was found to has perilymph gusher and converted to microscopic surgery. There were no intraoperative tympanic membrane injuries, facial nerve paresis or sensorineural hearing losses. The average preoperative ABG of patients who underwent fully endoscopic surgery was 31.3 dB, and the postoperative ABG closed up to 9.6 dB. CONCLUSIONS: Adoption of the two-handed technique during endoscopic stapes surgery ensures the surgeon benefits from the advantages of endoscopy while overcoming the disadvantages of the one-handed technique.