# Outcomes of Endoscopic Stapedectomy: Systematic Review

## TL;DR

This paper reviews endoscopic stapedectomy outcomes, showing improved hearing and fewer complications compared to traditional methods.

## Contribution

A systematic review demonstrating endoscopic stapes surgery as a viable alternative with shorter operation times and better visualization.

## Key findings

- Endoscopic stapes surgery provides significant hearing improvement with an air-bone gap gain of 9-16 dB.
- The technique is associated with shorter operative times and a lower complication rate.
- Better visualization and reduced scutum drilling were confirmed across included studies.

## Abstract

Introduction
 Stapes surgery was traditionally performed with the use of microscopy either through postauricular, endaural or transcanal approaches. Endoscopic stapedectomy ushered a revolution as a new technique with less complications.

Objective
 To review the outcomes of endoscopic stapes surgery with an emphasis on intraoperative and postoperative clinical and audiological results.

Data Synthesis
 A literature review on the PubMed, Web of Science, Scopus, the Cochrane Library, and Embase databases was conducted.
Endoscopic stapes surgery
or
stapedotomy
were the main keywords used, and we searched for studies and research published from January 2015 to October 2021. Articles on endoscopic stapes surgery were included, and qualitative and descriptive analyses of the studies and outcomes data regarding audiometric changes and postoperative complications were conducted. Articles including patients with cholesteatoma were excluded. A total of 122 studies were retrieved for qualitative and descriptive analyses and to measure the outcomes of endoscopic stapedotomy; only 12 studies met the inclusion criteria, and the rest was excluded. The meta-analysis revealed a statistically significant difference in hearing improvement. The gain in air-bone gap ranged from 9 dB to 16 dB. A low rate of operative and postoperative complications was reported.

Conclusions
 Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with shorter operative times, low complication rate, and significant hearing improvement. The endoscopic technique enabled a better visualization and less scutum drilling, which was confirmed by all included studies.