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

  • Graft Healing Process Following Cartilage Myringoplasty Without Trimming of the Perforation Margin April 12, 2024
    Objective: The objective of this study was to endoscopically evaluate the graft healing process and graft success rate following cartilage myringoplasty, without trimming of the perforation margin or external ear canal (EAC) packing. Material and Methods: Patients with chronic tympanic membrane (TM) perforation underwent endoscope cartilage underlay myringoplasty, without trimming perforation margin or EAC packing. […]
    Meixia Wu
  • Performance and Consistency of ChatGPT-4 Versus Otolaryngologists: A Clinical Case Series April 9, 2024
    CONCLUSION: ChatGPT-4 may be a promising adjunctive tool in otolaryngology, providing extensive documentation about additional examinations, primary and differential diagnoses, and treatments. The ChatGPT-4 is more effective in providing a primary diagnosis, and less effective in the selection of additional examinations and treatments.
    Jérôme R Lechien
  • Airway and Anaesthetic Management of Adult Patients with Mucopolysaccharidoses Undergoing Cardiac Surgery April 9, 2024
    Background: Mucopolysaccharidoses (MPSs) are rare congenital lysosomal storage disorders due to a deficiency of enzymes metabolising glycosaminoglycans, leading to their accumulation in tissues. This multisystem disease often requires surgical intervention, including valvular cardiac surgery. Adult MPSs have complex airways making anaesthesia risky. Methods: We report novel three-dimensional (3D) modelling airway assessments and multidisciplinary peri-operative airway […]
    David Mayhew
  • TCF1-LEF1 co-expression identifies a multipotent progenitor cell (T<sub>H</sub>2-MPP) across human allergic diseases April 8, 2024
    Repetitive exposure to antigen in chronic infection and cancer drives T cell exhaustion, limiting adaptive immunity. In contrast, aberrant, sustained T cell responses can persist over decades in human allergic disease. To understand these divergent outcomes, we employed bioinformatic, immunophenotyping and functional approaches with human diseased tissues, identifying an abundant population of type 2 helper […]
    Radomir Kratchmarov
  • Chronic stridor in a toddler after ingestion of a discharged button battery: a case report April 6, 2024
    CONCLUSION: This case describes the rare and unusual case of a long-term ingested, discharged BB. It underscores the need for heightened vigilance among healthcare providers regarding the potential hazards posed by discharged BBIs in otherwise healthy children with newly, unexplained stridor and feeding problems. This case emphasizes the critical role of early diagnostic imaging and […]
    Zoe S Oftring
  • Measuring the acoustic reflex through the tympanic membrane April 4, 2024
    CONCLUSION: The measured oscillations correlate well with those expected from a mechanical model of a damped harmonic oscillator, and the results of this work demonstrate the potential of interferometric spectrally encoded endoscopy to observe unique dynamical processes in the tympanic membrane and in the middle ear.
    Matan Hamra
  • Evaluation of the feasibility of endoscopic tympanoplasty in two-person three-hand operation April 2, 2024
    Objective:To study the difference of postoperative efficacy between two-person three-hand ear endoscopy and microscopic tympanoplasty in patients with chronic suppurative otitis media, and to explore the advantages and disadvantages of two-person three-hand ear endoscopy. Methods:A retrospective study was conducted on 100 patients who underwent tympanoplasty in the Department of Otolaryngology and Head and Neck Surgery […]
    Yiwei Chen
  • Polysomnographic airflow shapes and site of collapse during drug-induced sleep endoscopy March 28, 2024
    CONCLUSIONS: The current study provides a means to recognise patients with likely CCCp or other DISE-based site-of-collapse categories using routine polysomnography. Since site-of-collapse influences therapeutic responses, polysomnographic airflow shape analysis could facilitate precision site-specific OSA interventions.
    Sara Op de Beeck
  • Efficient management of benign laryngeal symptoms in an endoscopy outpatient clinic March 25, 2024
    CONCLUSIONS: Instructions for self-care and encouragement relieved concerns among patients with benign laryngeal symptoms. Moreover, symptoms improved significantly after a 1-month follow-up period.
    Pia Järvenpää
  • Endoscopic approaches to the orbit: Transnasal and transorbital, a retrospective case series March 21, 2024
    INTRODUCTION: Orbital pathologies requiring surgery are traditionally treated by open approach with different techniques depending on the lesion location. Recently, minimally invasive endoscopic approaches, such as the Endoscopic Endonasal Approach (EEA) and the Endoscopic Transorbital Approach (ETA) have been introduced in orbital surgery.
    Cesare Zoia