A Comparative Analysis of Microscopic and Endoscopic Stapedotomy: A Prospective Study.

Introduction: Stapedotomy is a procedure performed for the treatment of otosclerosis in which a small hole is created in the footplate stapes and a prosthesis is inserted from the incus to the vestibule. Objective: The present study aims to compare the benefits of endoscopic stapedotomy with those of microscopic stapedotomy. Methods: We included 20 patients of the Outpatient Department of Ear, Nose, and Throat (ENT) of a private medical college, who were diagnosed with otosclerosis and were scheduled to undergo stapedotomy. After they provided informed consent, the patients were randomly divided into two groups: group A underwent microscopic stapedotomy, and group B, endoscopic stapedotomy. Both the groups were compared in terms of intraoperative time, surgical approach, visualization of anatomical landmarks, extent of drilling of the posterosuperior part of external auditory canal, manipulation of the facial nerve, and postoperative pain, dizziness, and hearing loss. Results: A postural approach was required in 4 patients in group A. Visualization of the anatomical landmarks was better in group B. The extent of drilling of the posterosuperior part of the external auditory canal was minimal in group B, whose patients only experienced mild dizziness and low levels of pain postoperatively. Conclusion: Both techniques demonstrated high efficacy in improving hearing outcomes and reducing postoperative complications. Endoscopic stapedotomy offers enhanced visualization of anatomical landmarks and requires minimal drilling and minimal manipulation of the facial nerve. Moreover, the endoscopic procedure results in lower levels of postoperative pain and dizziness, as well as better cosmetic outcomes.