{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T17:10:26Z","timestamp":1782753026848,"version":"3.54.5"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The efficacy of the transcanal endoscopic approach in tympanoplasty, cholesteatoma removal, and stapedotomy is detailed. This study reviews evidence on the feasibility of endoscopic ossiculoplasty as a suitable alternative to traditional microscopic ossiculoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, Embase, and Cochrane Library were searched from inception to 19 June 2024 for articles comparing endoscopic and microscopic ossicular chain reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>This systematic review was conducted in accordance with PRISMA guidelines. The primary outcomes assessed include air bone gap closure, pre\u2010operative and post\u2010operative air bone gap, pure tone audiometry, and word recognition scores. The secondary outcomes include operation time, surgical success, and surgical complications. These outcomes between microscopic and endoscopic techniques were pooled and compared as mean differences using a random\u2010effects model. The Risk of Bias in Non\u2010Randomized Studies of Interventions (ROBINS\u2010I) and Cochrane Risk\u2010of\u2010Bias Tool for Randomized Trials (RoB2) scale were adopted to assess for study bias in observational studies and randomized controlled trials, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included five studies comprising 504 patients. While endoscopic ossiculoplasty had shorter operating durations (95% CI \u221242.97 to \u22121.57), it conferred comparable air bone gap closure (95% CI \u22120.34 to 3.76), post\u2010operative pure tone audiogram (95% CI 10.97\u201318.77), and surgical success. Additional qualitative strengths identified in endoscopic ear surgery include improvements in visualization, decreased need for supplemental incisions, excellent ergonomics, and reduced post\u2010operative pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall, endoscopic ossiculoplasty may confer comparable audiological outcomes to microscopic ossiculoplasty and may serve as a reasonable alternative surgical approach. <jats:italic>Laryngoscope<\/jats:italic>, 135:1899\u20131907, 2025<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31991","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T08:27:12Z","timestamp":1736411232000},"page":"1899-1907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of Endoscopic versus Microscopic Ossicular Chain Reconstruction\u2014A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6131-2240","authenticated-orcid":false,"given":"Chee Y.","family":"Lim","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-4615","authenticated-orcid":false,"given":"Brian S.Y.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery National University Hospital  Singapore Singapore"},{"name":"Division of Surgical Oncology National University Cancer Institute  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Y.S.","family":"Ngo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery National University Hospital  Singapore Singapore"},{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Ng Teng Fong General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woei S.","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery National University Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice D.","family":"Kwa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery National University Hospital  Singapore Singapore"},{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Alexandra Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1960.03770030085017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016485709130348"},{"issue":"6","key":"e_1_2_7_4_1","first-page":"877","article-title":"The history of the microscope for use in ear surgery","volume":"21","author":"Mudry A","year":"2000","journal-title":"Am J Otol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2020.09.003"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0000000000000298"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949910800106"},{"issue":"8","key":"e_1_2_7_8_1","first-page":"564","article-title":"Endoscopic ear surgery. Initial evaluation","volume":"107","author":"Thomassin JM","year":"1990","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0117-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.109872"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0000000000002353"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102451"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2673-z"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4661-1"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5153-7"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001527"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003235"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0000000000001339"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39057.406644.68"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28074"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003577"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0022215120002728"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2022.02.003"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06182-6"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3743-1"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-016-4428-0"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2017.01.001"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27496"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2017.01.013"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221503322683885"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2020.09.024"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116002693"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0000000000003858"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/oto2.162"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211041946"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.2147\/jpr.S144066"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atc.2004.11.013"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2017.08.001"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0022215117001694"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T03:57:20Z","timestamp":1752724640000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,9]]},"references-count":47,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/lary.31991"],"URL":"https:\/\/doi.org\/10.1002\/lary.31991","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,9]]},"assertion":[{"value":"2024-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}