내시경을 이용한 이소골성형술의 기능적 결과 및 학습곡선
Functional Results and Learning Curve of Endoscopic Ossiculoplasty
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Background and Objectives Endoscopes are recently being used to manage various middleear surgeries including ossiculoplasty. Here, we investigated hearing results of endoscopicossiculoplasty 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 to2020. Patients were divided into three groups: microscopic technique group (n=16); endoscopicearly phase group (n=16); endoscopic late phase group (n=16). Operation time and hearingresults including postoperative air-bone gap (ABG) and ABG closure were analyzed. Hearingoutcomes were considered “successful” when the postoperative ABG was less than 20 dB andconsidered “excellent” when ABG was less than 10 dB. The learning curve of the outcomeswere analyzed. Results Both operation time and postoperative ABG showed decreasing tendency, but onlyoperation time showed statistical significance. The ratio of successful and excellent operationsimproved, but did not show statistical significance. Improvement in learning curve was notstatistically significant presumably due to the lack of patient numbers. Conclusion Surgeon’s proficiency of endoscopic ossiculoplasty was correlated with the improvedclinical outcomes, and proficiently conducted endoscopic ossiculoplasty could be usedas a surgical technique comparable to microscopic ossiculoplasty.
Abstract
Background and Objectives Endoscopes are recently being used to manage various middleear surgeries including ossiculoplasty. Here, we investigated hearing results of endoscopicossiculoplasty 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 to2020. Patients were divided into three groups: microscopic technique group (n=16); endoscopicearly phase group (n=16); endoscopic late phase group (n=16). Operation time and hearingresults including postoperative air-bone gap (ABG) and ABG closure were analyzed. Hearingoutcomes were considered “successful” when the postoperative ABG was less than 20 dB andconsidered “excellent” when ABG was less than 10 dB. The learning curve of the outcomeswere analyzed. Results Both operation time and postoperative ABG showed decreasing tendency, but onlyoperation time showed statistical significance. The ratio of successful and excellent operationsimproved, but did not show statistical significance. Improvement in learning curve was notstatistically significant presumably due to the lack of patient numbers. Conclusion Surgeon’s proficiency of endoscopic ossiculoplasty was correlated with the improvedclinical outcomes, and proficiently conducted endoscopic ossiculoplasty could be usedas a surgical technique comparable to microscopic ossiculoplasty.
참고문헌 (20)
- Kozin ED, "Systematic review of outcomes following observational and operative endoscopic middle ear surgery", Laryngoscope, 125(5), pp.1205~1214 (2015)
- Sohn SJ, "Endoscopic tympanoplasty", Korean J Otorhinolaryngol-Head Neck Surg, 43(6), pp.598~603 (2000)
- Akyigit A, "Endoscopic tympanoplasty", J Otol, 12(2), pp.62~67 (2017)
- Isaacson B, "Endoscopic ossiculoplasty", Oper Tech Otolayngol Head Neck Surg, 28(1), pp.39~43 (2017)
- Nair S, "Endoscopic ear surgery: Our experience", Indian J Otolaryngol Head Neck Surg (2020)
- Bennett ML, "Comparison of middle ear visualization with endoscopy and microscopy", Otol Neurotol, 37(4), pp.362~366 (2016)
- 김효준, "Comparison of Intratympanic, Systemic, and Combined Steroid Therapies for Sudden Sensorineural Hearing Loss in Patients with Diabetes Mellitus", 대한이비인후-두경부외과학회지, 62(7), pp.379~384 (2019), 대한이비인후과학회
- Yung M, "Long-term results in ossiculoplasty : An analysis of prognostic factors", Otol Neurotol, 27(6), pp.874~881 (2006)
- Yawn RJ, "Audiometric outcomes following endoscopic ossicular chain reconstruction", Otol Neurotol, 38(9), pp.1296~1300 (2017)
- Dornhoffer JL, "Prognostic factors in ossiculoplasty : A statistical staging system", Otol Neurotol, 22(3), pp.299~304 (2001)
- De Vos C, "Prognostic factors in ossiculoplasty", Otol Neurotol, 28(1), pp.61~67 (2007)
- Park K, "Hearing result and its affecting factors of ossiculoplasty", J Clin Otolaryngol Head Neck Surg, 14(1), pp.105~112 (2003)
- Kim HC, "Factors influencing hearing outcomes after ossiculoplasty using Polycel®prosthesis in patients with chronic otitis medi", Korean J Audiol, 14(2), pp.88~93 (2010)
- Kartush JM, "Ossicular chain reconstruction. Capitulum to malleus", Otolaryngol Clin North Am, 27(4), pp.689~715 (1994)
- Emre IE, "Endoscopic ear surgery", J Otol, 15(1), pp.27~32 (2020)
- Das A, "Endoscopic ossiculoplasty : Is there any edge over the microscopic technique?", Laryngoscope, 130(3), pp.797~802 (2020)
- 전미혜, "내시경 귀 수술의 안전성 및 유효성: 체계적 문헌고찰", 대한이비인후-두경부외과학회지, 62(7), pp.367~378 (2019), 대한이비인후과학회
- Doğan S, "Endoscopic tympanoplasty : Learning curve for a surgeon already trained in microscopic tympanoplasty", Eur Arch Otorhinolaryngol, 274(4), pp.1853~1858 (2017)
- 함동훈, "직접전방 접근법을 통한 인공 고관절 치환술의 학습곡선", 대한정형외과학회지, 55(2), pp.143~153 (2020), 대한정형외과학회[DOI]
- Kim Y, "Learning curves for strabismus surgery in two ophthalmologists", Indian J Ophthalmol, 63(11), pp.821~824 (2015)