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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

  • Iatrogenic uvular necrosis after general anaesthesia July 21, 2026
    We report the case of a mid-30s parturient who presented with sore throat and dysphagia a day after undergoing laparoscopic right ovarian cystectomy under general anaesthesia. The procedure of intubation and extubation was straightforward and there were no complications in the airway intraoperatively. However, when she awoke the next day, she noticed white discolouration at […]
    Michael Casipe
  • Benign episodic unilateral mydriasis presenting as acute postoperative anisocoria July 21, 2026
    Acute anisocoria in the postoperative setting raises immediate concern for life-threatening intracranial or ophthalmic pathology. We report the case of a female patient in her 30s who developed a left-sided fixed dilated pupil following uncomplicated right-sided functional endoscopic sinus surgery. Urgent imaging and neurological evaluation were unremarkable. The patient had a history of migraine and […]
    Mark Knights
  • Endoscopic surgery: A narrative review of history, safety, and future perspectives, with lessons for transcanal endoscopic ear surgery (TEES) July 21, 2026
    The history of endoscopic surgery since the laparoscopic revolution offers critical lessons for the safe development of transcanal endoscopic ear surgery (TEES). Endoscopy evolved through three interdependent technological domains-illumination, light transmission, and imaging. Within otolaryngology, endoscopic sinus surgery (ESS) was established by the 1990s, yet TEES did not achieve mainstream adoption until approximately 2010. This […]
    Yu Matsumoto
  • Velopharyngeal Insufficiency Secondary to Endoscopic Endonasal Odontoidectomy and Craniocervical Fusion in a Pediatric Patient With Down Syndrome: A Case Report July 17, 2026
    IntroductionPost-operative morbidity is common (36%) in patients with Down Syndrome (DS) requiring surgical spine intervention. Underlying anatomical factors such as midface hypoplasia, shorter palates and hypotonia are also contributory. However, there are no reported cases on velopharyngeal insufficiency (VPI) following trans-nasal endoscopic odontoid resection and reconstruction.Case PresentationA 6-year old girl with Down Syndrome (DS) underwent […]
    Syeda Maria Ahmad Zaidi
  • Vocal cord immobility in Guillain-Barré syndrome: a diagnostic challenge July 17, 2026
    We present the case of a man in his 40s with Miller Fisher/Guillain-Barré overlap syndrome complicated by bilateral vocal cord (BVC) paralysis and respiratory failure. MRI, nerve conduction studies confirming motor-predominant axonal loss, and positive anti-GD1b and GM1 antibodies supported the diagnosis. Emergency intubation and tracheostomy for ventilatory weaning was required. Persistent BVC immobility despite […]
    Alex Penfold
  • A Physiologically Informed Modification Of Drug-Induced Sleep Endoscopy July 13, 2026
    No abstract
    Vik Veer
  • Traumatic vocal fold haemorrhage without airway compromise: a rare presentation of blunt laryngeal injury July 13, 2026
    Laryngotracheal trauma, although rare, can pose a significant threat to life. It may present subtly as illustrated by this case. It is crucial to maintain a high level of suspicion for signs indicative of laryngotracheal injury following blunt neck trauma. We present the case of a male in his 40s who presented following a fall […]
    Tara McSweeney
  • Nasal Leech in a Child July 8, 2026
    The common causes of epistaxis in children are mostly local mucosal dryness, trauma, or inflammation, while epistaxis caused by leech infestation is clinically rare and easily overlooked. This article reports a case of epistaxis in a child due to leeches and, combined with a literature review, analyzes its clinical characteristics and key points of diagnosis […]
    Changqing Wang
  • Superior Labial Artery Flap for Septal Perforation Repair: The Boxer's Flap July 8, 2026
    CONCLUSIONS: The SLA-based nasal floor flap provides high closure rates and symptomatic improvement in NSP cases where traditional septal flaps are not feasible.
    Nicholas J Campion
  • Clinical outcomes of surgical management in 19 cases of tympanic paraganglioma July 8, 2026
    Objective: To summarize the clinical experience and to evaluate the long-term outcomes of individualized surgical management for tympanic paraganglioma based on the modified Fisch-Mattox classification. Methods: A retrospective analysis was conducted on 19 patients (19 ears) with tympanic paraganglioma who underwent surgical treatment at our institution between 2014 and 2024. The cohort included 1 male […]
    Q Wang