Endoscopic approach in second stage ossicular chain reconstruction.

Abstract

PURPOSE\nToday limited studies regarding surgical and hearing outcomes in patients undergoing the totally endoscopic ossicular chain reconstruction has been published. The aim of this study is to show the different materials and endoscopic technique used in our experience to perform a second stage endoscopic ossiculoplasty.\n\n\nMATERIALS AND METHODS\nPatients underwent to second stage endoscopic ossiculoplasty has been enrolled in the study. According to the ossicular defect the endoscopic surgical procedures of ossicular chain reconstruction used in our clinical practice were: ossicular chain reconstruction using PORP (13 cases); ossicular chain reconstruction using TORP (11 cases); incus interposition ossiculoplasty (6 cases); cartilage ossiculoplasty (10 cases). Intraoperative and postoperative complications were analyzed. Final hearing recovery at 6\u202fmonths follow-up was used to evaluate audiological outcomes.\n\n\nRESULTS\nNone of the patients developed intraoperative complications. Postoperative TM complications emerged in 5% of cases: one patient (2.5%) presented TM perforation and prosthesis extrusion (TORP) after 3\u202fmonths follow up. A significative difference between preoperative and postoperative values of AC-PTA, ABG and WRS (p\u202f<\u202f0.05 in each case) emerged.\n\n\nCONCLUSIONS\nDifferent materials and methods can be used for performing an endoscopic ossicular chain reconstruction in order to obtain optimal clinical-audiological outcomes. Endoscopic surgery can be considered a valid alternative technique to traditional microscopic surgery for ossiculoplasty surgery.