Comparison of therapeutic effects of artificial stapes implantation with fenestration of the stapes floor between micro drill and three-edged needle for the treatment of ear sclerosis
Comparison of therapeutic effects of artificial stapes implantation with fenestration of the stapes floor between micro drill and three-edged needle for the treatment of ear sclerosis
Objective To compare the auditory outcomes and complications of using a microdrill and a three-edged needle in stapedotomy for stapes implantation under endoscopy in the treatment of otosclerosis.Methods Between March 2018 and February 2023,38 patients(48 ears)with otosclerosis who had undergone stapes surgery under endoscopy were admitted to our hospital.Among them,26 ears underwent stapedotomy with a microdrill(microdrill group),and 22 ears with a three-edged needle(three-edged needle group).All 48 ears received endoscopic stapedotomy and Piston implantation,using either a microdrill or a three-edged needle for the stapedotomy.The postoperative auditory outcomes,as well as complications such as dizziness,facial paralysis,sensorineural hearing loss,and intraoperative stapes accidents,were compared between the two groups.Results The postoperative mean air conduction(AC),mean bone conduction(BC),and mean air-bone gap(ABG)improved significantly compared to preoperative thresholds in the 48 ears(P＜0.05 for all).The microdrill group showed an average AC improvement of(23.5±12.6)dB HL,average BC improvement of(3.4±6.6)dB,and average ABG reduction of(20.1±5.6)dB HL.The three-edged needle group showed an average AC improvement of(21.4±11.8)dB HL,average BC improvement of(3.3±6.8)dB HL,and average ABG reduction of(18.1±4.3)dB HL,with no significant difference between the two groups(P＞0.05).Neither group experienced facial paralysis or sensorineural hearing loss postoperatively,and there was no significant difference between the two groups in terms of postoperative dizziness and intraoperative stapes accidents(P＞0.05 for both).Conclusions The effectiveness of using either a microdrill or a three-edged needle for stapedotomy in endoscopic stapes implantation surgery is similar,both requiring precise surgical skills and experience.However,the microdrill is more convenient and safer compared to the three-edged needle.
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