Endoscopic and minimally‐invasive ear surgery: A path to better outcomes

Abstract

The development of endoscopic ear surgery techniques promises to change the way we approach ear surgery. In this review paper, we explore the current evidence, seek to determine the advantages of endoscopic ear surgery, and see if these advantages are both measureable and meaningful. The wide field of view of the endoscope allows the surgeon to better visualize the various recesses of the middle ear cleft. Endoscopes make it possible to address the target pathology transcanal, while minimizing dissection or normal tissue done purely for exposure, leading to the evolution of minimally-invasive ear surgery and reducing morbidity. When used in chronic ear surgery, endoscopy appears to have the potential to significantly reduce cholesteatoma recidivism rates. Using endoscopes as an adjunct can increase the surgeon's confidence in total cholesteatoma removal. By doing so, endoscopes reduce the need to reopen the mastoid during second-look surgery, help preserve the canal wall, or even change post-cholesteatoma follow-up protocols by channeling more patients away from a planned second-look.

Otosclerosis: Experience With Stapes Surgery

“…Now the endoscopes have become the modern way of visualization in the surgical domain [19]. Recent studies on endoscopic stapes surgeries and outcomes have reported excellent audiological success rates [15,18]. All patients in the current study underwent conventional microscopic middle ear surgery.…”

“…The microscope is the conventional method used for middle ear surgeries, and the endoscope has been recently utilized as an alternative technique to view middle ear structures [15,16]. A microscope allows binocular vision and freedom of both hands with an unobstructed direct view of the operating field [17,18].…”

Bilateral Fracture of the Handle Malleus: A Case Report and Review of the Literature

“…In the surgical approach, the use of endoscopes exclusively or as an adjunct to the microscope permits the surgeons to greatly enhance the visualization of the target pathology and landmarks. [ 12 ] The laser-assisted tympanostomy is ideal for patients with a narrow ECA. With the laser beam, a high-precision tympanostomy can be performed very easily, giving a good visualization of the middle-ear cavity.…”

Oto-endoscopic Versus Microscopic Ventilation Tube Placement In Children

“…Wullstein used "ototypanoscope" from the company Storz with a diameter of 2,7 mm intraoperatively in 1984. In recent years 3 mm diameter oto-endoscopes are preferred to obtain better image quality [14] . In the current study, the smaller (2.7 mm diameter x 140 mm length) oto-endoscope was used without any problems in the paediatric age group.…”