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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

  • Oropharyngeal Lateral Wall Collapse as a Predictor of Hypoglossal Nerve Stimulation Response: A Systematic Review and Meta-Analysis August 7, 2026
    PurposeOropharyngeal lateral wall collapse (OPLW) on drug-induced sleep endoscopy (DISE) may influence outcomes after hypoglossal nerve stimulation (HNS) for obstructive sleep apnea (OSA). This systematic review and meta-analysis evaluates whether DISE-defined OPLW collapse is associated with HNS treatment success.MethodsPubMed, Embase, and Scopus were searched through February 2026. Eligible studies included adults undergoing HNS for OSA, […]
    Rahul D Patel
  • Innovations and Future Directions in the Management of Eustachian Tube Dysfunction August 5, 2026
    Innovations in Eustachian tube dysfunction (ETD) management are shifting care from symptom-based approaches toward precision, technology-integrated strategies. Advances in computational modeling, drug delivery systems (including hydrogels and nanoparticles), intranasal surfactants, and drug-eluting devices are expanding medical options. The potential role of biologics in type 2 inflammation and the effects of radiation and GLP-1 receptor agonists […]
    Dennis Poe
  • Two-handed endoscopic lateral temporal bone resection for squamous cell carcinoma of external auditory canal August 3, 2026
    A woman in her 20s presented with a 3-month history of progressive right-sided otalgia. Otoendoscopic examination revealed a greyish mass occluding more than 75% of the external auditory canal. Biopsy confirmed well-differentiated squamous cell carcinoma. High-resolution CT demonstrated cortical erosions of the anterior and posterior bony external auditory canal with mastoid involvement. The patient underwent […]
    Deviprasad Dosemane
  • Effect of Colored Ear Specula on Halation Reduction and Otoscopic Visibility Under a 4K-3D Exoscope July 28, 2026
    CONCLUSIONS: White provided the most favorable overall balance between halation suppression and perceived visibility, with silver as a reasonable alternative. Inner-surface color is a low-cost design variable that can materially influence exoscopic otoscopy.
    Ayaka Tsuzaki
  • Loss of vision secondary to a sphenoid fungal ball with full post-surgical recovery July 27, 2026
    An older adolescent immunocompetent male with a 2 month history of progressive frontal headaches, congestion and worsening vision, culminating in right optic neuropathy, was referred to our emergency department by ophthalmology. MRI revealed extensive sinus disease, though without direct optic nerve compression; CT scan identified a fungal ball extending into the right clinoid process, with […]
    Anna Onderková
  • 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