Primary Endoscopic Stapes Surgery: A Comparison of Adipose Tissue and Gelfoam Seal

Abstract

To compare the efficacy between the commonly used sealing materials, i.e., adipose tissue and the gelfoam in primary endoscopic stapedotomy. Lobular fat and gelfoam have been used in patients who underwent endoscopic stapedotomy between two groups, each containing 29 patients. The hearing outcomes and postoperative complications were compared at the end of 12 weeks between two groups. The ABG of ≤ 10 dB was achieved in 69% of cases in group A and 76% of cases in group B. There was a significant short-term (1 week) improvement in the Dizziness Handicap Inventory score (p = 00) with patients of adipose tissue seal compared to the gelfoam. Although the audiological outcomes were comparable between the two groups, the use of the adipose tissue can be a better alternative than gelfoam to control vertigo in the early postoperative period without causing any significant morbidity to the patient.

Keywords: Adipose tissue seal; Comparison; Endoscopic stapes surgery; Gelfoam seal.

Fig. 1

Transcanal incision given (Right ear) from 6 o’clock to 12 o’clock poison

Fig. 2

Complete exposure of stapes suprastructure

Fig. 3

Fenestra was made over the stapes footplate with 0.8 mm perforator

Fig. 4

Teflon piston (0.6 mm diameter, 4.25 mm length) was inserted through the stapedial window, anchored over the long process of incus, and a piece of lobular fat was used to seal the stapedial window after the insertion of the piston

Fig. 5

Study design

Fig. 6

Diagram shows the comparative DHI scores between fat and gelfoam plugging at the end of 1,4 and 12 weeks in the postoperative period