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Otoendoscopy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
David A. Bowdler, Annabelle C.K. Leong, David D. Pothier
There are two schools of thought when it comes to selecting which type and size of endoscope to use for ear surgery. Many otologists will use both operating microscope and endoscopes symbiotically, performing part of their surgery with 2.7 mm diameter 0, 30 and 45 degree endoscopes and rarely, using the 70 degree endoscope as well as the 1.9 mm endoscopes, especially to pass through the posterior tympanotomy. Others may undertake the majority of their surgery using a 14–18 cm long 4 mm diameter 0 degree Hopkins rod and endoscope, the very same endoscope used for sinus surgery (Figure 87.7). The latter practice has been termed endoscopic ear surgery (EES) to denote its distinction from the former and is steadily gaining popularity among some otologists.17,23,24 The advantages of using a longer and wider endoscope include a wider field of view, as well as the fact that the surgeon’s hands are farther away from the ear canal and hence less likely to interfere with one another intra-operatively.
Outcomes of transcanal endoscopic middle ear surgery for congenital cholesteatoma
Published in Acta Oto-Laryngologica, 2023
Lianrong Guo, Yongjin Su, Zhi Cai, Yuanyuan Yang
Some limitations of our study should be acknowledged. First, owing to the rarity of CC, the sample size of our study was small, which may result in bias. Second, we did not perform a statistical comparison with microscopic surgery; nevertheless, our results show that for CCs in stages 3 or below, endoscopic ear surgery is safe and associated with low rates of recurrence and complications. Furthermore, although no cases of stage-4 CC were included in this study, we have performed endoscopic surgery for patients with acquired cholesteatoma involving the mastoid and achieved good results. Therefore, endoscopic surgery through the ear canal is a good surgical method for the treatment of CC. However, mastering otoscopic surgery requires professional training and practice, especially in pediatric patients, who have a narrow ear canal.
Transcanal endoscopic management of isolated congenital middle ear malformations
Published in Acta Oto-Laryngologica, 2023
Licai Shi, Shuainan Chen, Rujie Li, Yideng Huang
With the development of video imaging systems and a series of ear surgical instruments, endoscopic ear surgery has been widely used in middle ear surgery. Multiple meta-analyses showed that myringoplasty, tympanoplasty and stapes surgery by total TEES was very safe and effective [15,16]. In summarizing the literature published in Pubmed reported that the success rate of total endoscopic ear surgery for CMEMs ranged from 71 to 92%, as shown in Table 5. Notably, on account that endoscopic ear surgery must be performed one-handed, it can be troublesome to deal with some complications like stapes gusher. Therefore, it is necessary to read imaging carefully of preoperative HRCT to exclude inner ear malformations, which can significantly reduce the risk of cerebral spinal fluid gusher and sensorineural hearing loss.
Comparison of type I tympanoplasty with acellular dermal allograft and cartilage perichondrium
Published in Acta Oto-Laryngologica, 2019
Zifei Yang, Xianmin Wu, Xiaoyun Chen, Yideng Huang, Lian Fang, Xiaofei Li, Yue Zhang, Minghui Jia
All patients were subjected to transcanal endoscopic ear surgery under general anesthesia. The AlloDerm was cut to a suitable size that is slightly larger than the perforation. After marginal trimming, the basement membrane of the AlloDerm is placed outwardly and under the tympanic membrane margin above the handle of malleus. After the procedure, we covered the graft with gelatin sponge particles and stuffed the external auditory canal with iodine spun yarn. The cartilage perichondrium obtained from the tragus cartilage was used for perichondrium tympanoplasty with the same surgical conditions. Antibiotics were used for 1 week as a preventive treatment. An audiogram and otoscopy were performed at 6 months after surgery to assess the hearing outcomes and graft healing in patients.