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

  • Diagnosis and Management of Giant Esophageal Fibrovascular Polyp With Hypopharyngeal Pedicle November 29, 2021
    Background: Fibrovascular polyps (FVPs) with hypopharyngeal pedicles (hFVPs) are the rare intraluminal benign tumours of the upper aerodigestive tract, and their accurate diagnosis and optimal management are challenging. Purpose: The present retrospective study attempted to explore the optimal diagnosis and treatment of hFVPs. Research Design: The clinical records of 2 patients with giant, irregularly shaped […]
    Wan-Xin Li
  • An Induction Programme Used to Improve Confidence General Practitioner Trainees in Managing Hospital Ear, Nose and Throat Emergency Presentations November 19, 2021
    CONCLUSION: There was a greater level in confidence in managing ENT presentations of those who completed the induction program, and we recommend a similar structured programme for GP trainees who rotate in ENT. This may have wider implications in fostering interest in postgraduate degrees in ENT and improving the quality of primary care management of […]
    Anushree Kucheria
  • Periostin as a Biomarker of Allergic Inflammation in Atopic Bronchial Asthma and Allergic Rhinitis (a Pilot Study) November 19, 2021
    CONCLUSION: Exacerbation and increased severity of AR in patients with atopic BA are accompanied by an increased level of periostin in the nasal secretion. This allows us to consider the level of nasal periostin as a biomarker of local allergic inflammation in the NM of patients with atopic BA combined with AR. Hypertrophic changes in […]
    S V Krasilnikova
  • Ear, Nose, and Throat Practice Guidelines: An Update for COVID-19 November 15, 2021
    Introduction Amidst another wave of COVID-19, the alarming number of cases per day in India has affected the healthcare system and professionals tremendously. As the disease burden continues to increase, ear, nose, and throat (ENT) specialists remain at high risk of exposure to this aerosol borne virus. This requires the creation and regulation of protocols […]
    Sahil Kapoor
  • Flexible Nasal Endoscopic Procedures in Family Medicine: Indications and Effectiveness November 15, 2021
    CONCLUSIONS: Flexible nasal endoscopic procedures are effective in the care of patients in a family medicine residency center and can be safely performed and taught to residents.
    John Malaty
  • Giant Pharyngeal Recess Cyst: A Case Report November 10, 2021
    A pharyngeal recess cyst is a benign lesion, located at the nasopharyngeal recess with limited development. Pharyngeal recess cysts rarely occur. This case report describes a young male patient presenting with a foreign body sensation in the pharynx. Electronic nasopharyngoscope examination revealed a large nasopharyngeal cyst, whose root was located in the left pharyngeal recess. […]
    Dong Liu
  • Combined Endoscopic/Microscopic Cochlear Implantation Through the Oval Window November 8, 2021
    Standard round window (RW) cochlear implantation is a well-described technique. Implantation might be difficult in patients with inner and middle ear anomalies, in some cases because of not achieving adequate exposure to the RW, with a related higher risk of complications such as facial nerve injury. It is proposed a combined microscopic/endoscopic oval window approach […]
    Italo Cantore
  • Congenital bilateral choanal atresia: an endoscopic approach with multi-flaps supported by neuronavigated CT November 3, 2021
    We present a case of a 2-month-old patient with CHARGE syndrome, cerebral haemorrhage and bilateral congenital choanal atresia (CCA). He was admitted to our otorhinolaryngology unit to solve his congenital bilateral choanal atresia proposing a transnasal endoscopic surgery. A study of CT of the skull showed that the air column was interrupted on both sides […]
    Cosimo Galletti
  • Burkholderia Cepacia Causes Frontal Mucopyocele with Anterior Cranial Fossa Extension: A Novel Case Report October 25, 2021
    CONCLUSION: Paranasal sinuses disease with cranial expansion and orbital complications constitutes an emergency. For the first time in the literature, Bcc was isolated in the frontal sinus, extending into the anterior cranial fossa, in an immunocompetent patient. An endoscopic surgical approach with microbiological identification and management by appropriate antibacterial drug treatment seems to be the […]
    Athanasios Saratziotis
  • Robot-Assisted Middle Ear Endoscopic Surgery: Preliminary Results on 37 Patients October 25, 2021
    Background: Endoscopy during middle ear surgery is advantageous for better exploration of middle ear structures. However, using an endoscope has some weaknesses as surgical gestures are performed with one hand. This may trouble surgeons accustomed to using two-handed surgery, and may affect accuracy. A robot-based holder may combine the benefits from endoscopic exposure with a […]
    Marine Veleur