No abstract

During middle ear endoscopy, patients frequently experience vertigo. We theorized that this effect is secondary to heat produced by the scope. We evaluated two Hopkins rods and two fiberoptic scopes to assess the temperature elevation at the lateral semicircular canal (LSCC) of temporal bones and in a live canine model. These results were compared to the results of a standard 44 degrees C water caloric. We demonstrated in both models that the temperature rise at the LSCC increased relative to the scope diameter and that the Hopkins rods produced the same or greater heating effect than a warm caloric. Direct exposure of the thermocouple to the light produced a greater temperature elevation. We conclude that endoscopes produce sufficient heat to induce caloric stimulation of the LSCC. Care should be exercised to prevent the possibility of thermal injury.

Our survey provides a picture of NOE management in the UK. While there is consensus in some aspects of NOE management, other aspects attract widely differing answers. This may reflect the lack of strong evidence in the literature. Future work should aim to address this.

Cholesteatoma remains a disease with significant morbidity. Endoscope-assisted surgery may decrease the morbidity of second look surgery and may improve the clearance of disease in appropriately selected patients.