Compare intraoperative and postoperative outcomes of endoscopic and microscopic stapes
surgery to provide objective evidence on whether the former is a better alternative
than the latter.We performed a systematic review and meta-analysis for studies that
compared endoscopic stapes surgery with microscopic stapes surgery. Only studies that
met predetermined criteria were selected and assessed for bias and quality. Primary
outcomes were postoperative air-bone gap (ABG) and chorda tympani nerve injury. Secondary
outcomes were average operating time, tympanic membrane (TM) perforation, and postoperative
taste disturbance, pain, and dizziness. We calculated pooled odds ratios (ORs) with
95% confidence intervals (CIs) for dichotomous outcomes and weighted mean difference
(WMD) with 95% CI for continuous outcomes. A confidence interval starting above 1.0
was considered as statistically significant. I2 and χ2 tests were used to quantify
statistical heterogeneity. We used funnel plots to look for publication bias and performed
a sensitivity analysis.Six nonrandomized cohort studies were eligible. The primary
outcomes were ABG < 10 dB: OR = 1.80 (95% CI: 0.96 to 3.38), ABG = 11 dB to 20 dB:
OR = 1.49 (95% CI: 0.76 to 2.93), ABG > 20 dB: OR = 2.51 (95% CI: 0.77 to 8.22), and
chorda tympani injury: OR = 3.51 (95% CI: 1.55 to 7.93). Secondary outcomes were taste:
OR = 2.36 (95% CI: 1.01 to 5.51), average operation time: WMD = 0.14 (95% CI: -11.69
to 11.98), TM perforation: OR = 1.70 (95% CI: 0.44 to 6.58); pain: OR = 0.84 (95%
CI: 0.36 to 1.96), and dizziness: OR = 2.15 (95% CI: 0.94 to 4.89).Endoscopic stapes
surgery is a valid alternative to the microscope.2a Laryngoscope, 2019.
