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Rationale for Endoscopic Ear Surgery

In clear contrast to the impact of the introduction of endoscope in most surgical disciplines, the practice of ear surgery has changed little and it continues to be the domain for the microscope. Depending on the task at hand, there are many distinctions that would make the endoscope a better instrument than the microscope and vice versa. We all need to master working with both instruments to better understand and treat pathologies of the ear. The objective of this group and this web site is to neutralize these longstanding biases toward the microscope and to get all of us to use the best instrument in the best way possible to help our patients.

The ability to place the surgeons eyes within the ear cavity using angled endoscopes, allows the operator a contextual understanding of the anatomy that is difficult to match using the microscope.  The disease/ anatomical interface is better appreciated.  This improved anatomical understanding, in turn provides confidence in surgical procedures both endoscopically and microscopically.

When compared to the microscope, two distinct advantages are present with the endoscope.

  1. The Objective lens is placed within the ear canal or middle ear, which allows for an all-encompassing contextual view of the disease/ anatomy interface.  In contrast, the traditional microscopic method relies on removal of significant amounts of normal bone and soft tissue, often with removal of intact structures to fully observe the disease extent.
  2. The live image used by the surgeon is the same one that everyone else in the operating room is observing. This simultaneous viewing significantly increases engagement, teaching opportunities and interest in the surgical procedure from all present in the OR.
enscopic ear surgery field of view

The use of the endoscope enables the surgeon to visualize past the shaft of larger surgical instruments, such as drills and curettes, and allows better visualization of anatomical structures.

 

To view the up to date research on Endoscopic Ear Surgery, please visit the link below.

RSS endoscopy ear

  • Does drug induced sleep endoscopy induce upper airway obstruction? November 16, 2025
    CONCLUSIONS: This study demonstrated a high percentage of children with no clinical history suggesting OSAS but who had bronchoscopic evidence of obstruction. When performing a bronchoscopy to assess OSAS, clinicians should be aware that the procedure may induce or exaggerate findings that must be taken into account before making therapeutic or surgical decisions.
    Leon Joseph
  • Vagal Neuropathy From an Ear Foreign Body: A Black Swan Event in Clinical Practice November 13, 2025
    CONCLUSION: This case highlights a novel mechanism of cranial neuropathy, direct FB migration to the skull base, and underscores the importance of reevaluating imaging in refractory otologic cases. Clinicians should suspect occult FBs in pediatric patients with persistent ear bleeding and cranial nerve deficits, even without a clear history of insertion.
    Ahmed H Thabet
  • Integration of Trackerless Surface Reconstruction-Based Surgical Navigation With Exoscopic Trans-Mastoid Surgery November 12, 2025
    CONCLUSION: A SLAM-based surgical navigation system can enable accurate localization of anatomic points of interest, which is maintained throughout exoscopic surgical dissection and between alternating use of exoscopy and endoscopy. With further development, this approach to navigation has the potential to provide accurate and continuous navigation data during lateral skull base surgery without compromising surgical […]
    Ryan A Bartholomew
  • Characteristics of Pharyngeal Foreign Bodies on Flexible Fiberoptic Endoscopy November 11, 2025
    CONCLUSIONS: Pharyngeal FBs occur more frequently in younger patients and at the root of the tongue. Hypopharyngeal injury is a likely cause of FB sensation in patients with no FB detected on endoscopy.
    Yongming Pan
  • Dysphonia in Hospitalized Patients November 8, 2025
    Dysphonia, or impaired voice quality, is common in hospitalized patients and can impair communication, signal underlying disease, and worsen outcomes. Ultimately, this negatively impacts quality of life, increases resource utilization, and often coexists with dysphagia. Causes include surgical injury, intubation, infection, neurologic disease, and malignancy. Diagnosis relies on history and physical examination, often inclusive of […]
    Adam R Szymanowski
  • Anteriorly-based nasal floor mucoperiosteal flap for septal perforation November 4, 2025
    CONCLUSION: The anteriorly-based nasal floor mucoperiosteal flap yields favorable outcomes in patients with septal perforation, with minimal morbidity.
    Tamer Oraby
  • Efficacy of combined microscopic-endoscopic resection of petrous bone cholesteatoma via cochlear-carotid recesses with cochlear preservation November 3, 2025
    The data of three patients (two males and one female) aged 19-30 years who underwent combined microscopic-endoscopic surgery via the cochlear-carotid recesses for petrous bone cholesteatoma (PBC) at the Eye & ENT Hospital of Fudan University from June 2017 to August 2022 were retrospectively analyzed. All patients achieved complete cholesteatoma resection with cochlea preservation. No […]
    M Y Ma
  • The impact of nasal mask versus oronasal mask CPAP treatment on the site of collapse and the differences in physiologic state November 3, 2025
    CONCLUSION: Nasal masks were more effective than oronasal masks in reducing airway obstruction and maintaining oxygenation during CPAP therapy, suggesting anatomical and physiological advantages that may guide personalized mask selection in OSA management.
    Jongmin Kim
  • Predictive Modeling of Surgically Recalcitrant Chronic Rhinosinusitis Using Integrated Feature Sets October 31, 2025
    CONCLUSION: Integrating multiple clinical and inflammatory feature sets significantly enhances the predictive modeling of surgical history in CRS patients. These findings highlight the importance of multimodal data integration for improving classification performance and provide valuable insights for developing more accurate and clinically applicable ML models in CRS. The code has been made publicly available through […]
    Xindong Zheng
  • Reducing AL After Double-Stapling Anastomosis: A Novel Laparoscopic Technique for Dog Ear Area Resection October 28, 2025
    CONCLUSIONS: In this retrospective study, laparoscopic "dog ear" resection before DSA was associated with reduced AL risk and did not compromise surgical safety in colorectal cancer surgery, suggesting it may be a feasible refinement to standard procedures. These associations, however, require validation through prospective studies.
    Yuan Jinpeng