Table 1 Surgical steps of endoscopic stapedotomy for 74 patients, complications, and associated interventions during the 5 years (2016–2020) of the study. IS incudostapedial joint, 1ry primary, ABG air bone gap
From: Experience in endoscopic stapedotomy technique and its audiological outcome: a case series
Procedure/structure | Associated complication/finding | Incidence during the 5 years of the study | Management of complications and remarks |
|---|---|---|---|
Tympanomeatal flap elevation: intact flap in 70 patients (94.6%) | Tear in 4 patients (5.4%) | 1st year | Grafted by: perichondrium, fat, or vein graft |
Scutum curette: performed for 65 patients (87.8%) | Inadequate in 3 patients (4.05%) | 1st and 2nd years | Prolongation 11 min of surgery as re-curette was required |
Over removed in 1 patient (1.4%) | 1st year | Shortened flap, supported by thin tragal cartilage | |
-Stapedius tendon -Separation of IS joint -Fracture of crura | None | -------------- | ------------------------------------------ |
Chorda tympani | Stretched in 1 patient (1.35%) | 2nd year | Asymptomatic No reported taste disturbance |
Fenestration of the oval window (stapedotomy) | Perilymph gush 1 patient (1.4) | 3rd year | Leak stopped after placement of prosthesis |
Prosthesis insertion: successful 1st trial insertion in 65 patients (87.8%) | Subluxation of incus in 1 patient (1.4%); several trials of insertion | 1st year | Cessation of surgery, revised 6 months later with successful prosthesis insertion in second surgical session |
Anesthesia: local in 71 patients (96%), general in 3 patients (4%) | Conversion from local to general in 1 patient (1.4%) | 1st, 2nd, and 3rd years, 1/year | Two patients were scheduled for general anesthesia upon their request |
Revision stapedotomy: one patient, 48 h after 1ry surgery | Displacement of prosthesis off incus and fenestra | 3rd year | Severe cough and vertigo 10 h after 1ry surgery. Reposition of prosthesis ABG was closed after revision |