Korean J Otorhinolaryngol-Head Neck Surg.  2022 Nov;65(11):678-683. 10.3342/kjorl-hns.2021.00535.

Functional Results and Learning Curve of Endoscopic Ossiculoplasty

• Lee MK
• An YY
• Lee YJ
• Lee JH
• Lee SA
• Lee JD

• KMID: 2536182
• DOI: http://doi.org/10.3342/kjorl-hns.2021.00535

Abstract

Background and Objectives
Endoscopes are recently being used to manage various middle ear surgeries including ossiculoplasty. Here, we investigated hearing results of endoscopic ossiculoplasty and surgeon’ learning curve in gaining endoscopic ossiculoplasty proficiency. We compared the results with those of microscopic ossiculoplasty.
Subjects and Method
We analyzed 48 patients of ossiculoplasties performed from 2010 to 2020. Patients were divided into three groups: microscopic technique group (n=16); endoscopic early phase group (n=16); endoscopic late phase group (n=16). Operation time and hearing results including postoperative air-bone gap (ABG) and ABG closure were analyzed. Hearing outcomes were considered “successful” when the postoperative ABG was less than 20 dB and considered “excellent” when ABG was less than 10 dB. The learning curve of the outcomes were analyzed.
Results
Both operation time and postoperative ABG showed decreasing tendency, but only operation time showed statistical significance. The ratio of successful and excellent operations improved, but did not show statistical significance. Improvement in learning curve was not statistically significant presumably due to the lack of patient numbers.
Conclusion
Surgeon’s proficiency of endoscopic ossiculoplasty was correlated with the improved clinical outcomes, and proficiently conducted endoscopic ossiculoplasty could be used as a surgical technique comparable to microscopic ossiculoplasty.

Keyword

Conductive hearing loss; Endoscopy; Learning curve; Microscopy; Ossicular replacement