Endoscopic ear surgery: Does it have an impact on quality of life? Our experience of 152 cases

Taneja, Virangna; Milner, Thomas D.; Iyer, Arunachalam

doi:10.1111/coa.13459

Cited by 11 publications

(5 citation statements)

References 8 publications

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“…These innovative strategies should be applied to tackle the increase in aerosol generation during mastoidectomy as identified in this study. However, the use of a minimally invasive therapeutic strategy appears to be beneficial to the patient 24 , 25 and may also increase the safety and well-being of the operating room personal.…”

Section: Discussionmentioning

confidence: 99%

Quantification and Comparison of Droplet Formation During Endoscopic and Microscopic Ear Surgery: A Cadaveric Model

Anschuetz

Yacoub

Buetzer

et al. 2020

Otolaryngol.--head neck surg.

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Objectives The COVID-19 pandemic and the disproportional spread of the disease among otorhinolaryngologists raised concerns regarding the safety of health care staff. Therefore, a quantitative risk assessment for otologic surgery would be desirable. This study aims to quantitatively compare the risk of perioperative droplet formation between microscopic and endoscopic approaches. Study Design Experimental research. Setting Temporal bone laboratory. Methods The middle ear of whole head specimens was injected with fluorescein (0.2 mg/10 mL) before endoscopic and microscopic epitympanectomy and mastoidectomy. Fluorescent droplet deposition on the surgical table was recorded under ultraviolet light, quantified, and compared among the interventions. Drilling time, droplet proportion, fluorescein intensity, and droplet size were assessed for every procedure. Results A total of 12 procedures were performed: 4 endoscopic epitympanectomies, 4 microscopic epitympanectomies, and 4 mastoidectomies. The mean (SD) proportion of fluorescein droplets was 0.14‰ (0.10‰) for endoscopic epitympanectomy and 0.64‰ (0.31‰) for microscopic epitympanectomy. During mastoidectomy, the deposition of droplets was 8.77‰ (6.71‰). Statistical comparison based on a mixed effects model revealed a significant increase (0.50‰) in droplet deposition during microscopic epitympanectomy as compared with endoscopic epitympanectomy (95% CI, 0.16‰ to 0.84‰). Conclusions There is considerable droplet generation during otologic surgery, and this represents a risk for the spread of airborne infectious diseases. The endoscopic technique offers the lowest risk of droplet formation as compared with microscopic approaches, with a significant 4.5-fold reduction of droplets between endoscopic and microscopic epitympanectomy and a 62-fold reduction between endoscopic epitympanectomy and cortical mastoidectomy.

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Section: Discussionmentioning

confidence: 99%

Quantification and Comparison of Droplet Formation During Endoscopic and Microscopic Ear Surgery: A Cadaveric Model

Anschuetz

Yacoub

Buetzer

et al. 2020

Otolaryngol.--head neck surg.

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“…Trans‐canal endoscopic ear surgery (TEES) was introduced in the 1990s, and since then, an increasing number of studies has described the various applications and safety of the endoscopic approach 1‐3 . The main advantages of TEES are the magnification of the surgical field, the improved visualisation of anatomical recesses, the avoidance of external incisions and mastoid drilling, the reduction in pain and operation time and improved quality of life 4 . Our study aimed to analyse the TEES outcomes to identify the effect of a learning curve.…”

Section: Objectivesmentioning

confidence: 99%

“…[1][2][3] The main advantages of TEES are the magnification of the surgical field, the improved visualisation of anatomical recesses, the avoidance of external incisions and mastoid drilling, the reduction in pain and operation time and improved quality of life. 4 Our study aimed to analyse the TEES outcomes to identify the effect of a learning curve.…”

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confidence: 99%

Learning curve in endoscopic tympanoplasties: A prospective study based on outcomes of 141 cases

Fradeani

Milner

Iyer

2021

Clinical Otolaryngology

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Trans-canal endoscopic ear surgery (TEES) was introduced in the 1990s, and since then, an increasing number of studies has described the various applications and safety of the endoscopic approach. [1][2][3] The main advantages of TEES are the magnification of the surgical field, the improved visualisation of anatomical recesses, the avoidance of external incisions and mastoid drilling, the reduction in pain and operation time and improved quality of life. 4 Our study aimed to analyse the TEES outcomes to identify the effect of a learning curve. | DE S I G N | Study design and settingA prospective study of TEES tympanoplasties performed in one centre by a single senior otologist, from 2014 when TEES was introduced till 2018. All the patients had chronic otitis media (COM) with or without cholesteatoma. STROBE reporting guidelines have been followed in conducting this study. | Statistical analysisDependant variables were as follows: tympanoplasty success (intact tympanic membrane and non-discharging ear (yes/no)) and hearing gain (dB) as a secondary outcome measure. Independent variables are highlighted in Table 1. Analyses included univariate (UVA) chi-Squared tests and general linear models, and multivariate (MVA) general linear models, with Bayesian information criterion (BIC) factor extraction. Variance inflation factor was utilised to identify co-variates. Cartilage use and ossicular reconstruction required exclusion from MVAs as they demonstrated too much co-variance when analysed in conjunction with other variables. A moving average (MA) assessment was performed with an analysis of the relationship using Spearman's rank correlation coefficient. Statistical testing was performed with the use of R statistical software through RStudio (version 1.1.463). Pvalues < .05 were considered statistically significant. | Surgical techniqueThe procedures were performed using 14 cm rigid endoscopes (Storz ® , Tuttlingen Germany), and HD 3CCD chip cameras (Stryker ® , Kalamazoo USA). The operations performed were myringoplasties, tympanoplasties, atticotomy or atticoantrostomy, with or without ossiculoplasty. In 106 cases, the graft material used was tragal cartilage-perichondrium. Temporalis fascia was used in 3 and porcine submucosa graft (Biodesign ® , Cook medical) was used in 34 and details are not available in one (Table 1). | PARTI CIPANTSA total of 141 tympanoplasties were performed, which included 76 females and 65 males, with a mean age of 33 years (5-77), 71 were on the left and 70 on the right side (Table 1). Operations in which a graft was not performed and patients who had less than 6 months of follow-up or incomplete information were excluded. | Post-operative follow-upPatients' first follow-up was normally after 20 days in cases requiring packing removal. All patients were then reviewed at 3, 6 and 12 months and every 12 months for the next 5 years in cases of cholesteatoma. | Data collectionAll data were entered prospectively in the Common Otology Audit (http://www.ear-audit.net/), a web-based international...

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“…A wider field of view provides better visualization of hidden areas within the middle ear without the need for a postauricular incision or drilling the mastoid bone (1). Totally (or transcanal) endoscopic ear surgery (TEES) avoids the requirement for an external incision with the advantages of less postoperative pain and higher patient satisfaction and quality of life (2)(3)(4). Other important outcomes including peforation closure, cholesteatoma recividism and hearing thresholds are at least as good as those from microscope-guided surgery (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

A Novel Instrument for Endoscopic Ear Surgery With a Steerable Flexible Tip: A Pediatric Anatomical Validation Study

Chayaopas

Swarup

Eastwood

et al. 2021

Otology &Amp; Neurotology

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Hypothesis: This study compares the reaching ability of two classes of transcanal endoscopic ear surgery (TEES) instruments when operating on difficult to access anatomical targets; two novel instruments with steerable flexible tips (SFT-A and SFT-B) and suction capability are compared with standard commercially available tools. Background: TEES surgeons identified the need for a new surgical instrument that can enable accessibility of all areas visualized by the endoscope. This motivated the development of the two instrument prototypes. Methods: Six temporal bone models were 3D printed based on CT data from five cholesteatoma patients. Four anatomical targets were marked on each model. Using these targets, the reaching ability while using four standard TEES instruments were compared with the SFT-A and SFT-B prototypes by five surgeon participants. Results were analysed to compare success rates of contacting each target using each tool by fitting four Firth's logistic regression models. This calculated the statistically significant differences ( p < 0.05) in tool success rate. Results: Using SFT-A to contact the sinus tympani (100%) was significantly more successful than the Panetti suction dissector for atticus (PAT) (77%) and to contact the sinodural angle (0%) was less successful than the PAT (10%) and SFT-B (93%). Using SFT-B to contact the lateral semicircular canal (90%) was significantly more successful than all current tools and to contact the sinodural angle (93%) was significantly more successful than all tools. Conclusion: Using SFT-B enables enhanced accessibility of anatomical structures during TEES which may lead to less extensive bone removal to facilitate minimally invasive TEES.

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Endoscopic ear surgery: Does it have an impact on quality of life? Our experience of 152 cases

Abstract: Glasgow Benefit Inventory scores were higher in all domains for endoscopic cases compared to open and combined cases (Table 1).

Cited by 11 publications

References 8 publications

Quantification and Comparison of Droplet Formation During Endoscopic and Microscopic Ear Surgery: A Cadaveric Model

Quantification and Comparison of Droplet Formation During Endoscopic and Microscopic Ear Surgery: A Cadaveric Model

Learning curve in endoscopic tympanoplasties: A prospective study based on outcomes of 141 cases

A Novel Instrument for Endoscopic Ear Surgery With a Steerable Flexible Tip: A Pediatric Anatomical Validation Study

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