Facial sinus endoscopic evaluation, radiologic assessment, and classification

Alicandri‐Ciufelli, Matteo; Fermi, Matteo; Bonali, Marco; Presutti, Livio; Marchioni, Daniele; Todeschini, Alice; Anschuetz, Lukas

doi:10.1002/lary.27135

Cited by 29 publications

(34 citation statements)

References 20 publications

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“…The use of rod lens endoscopes inside the middle ear provides the surgeon with wide-angled panoramic views of the anatomy and pathology. Moreover, angled scopes reach hidden areas of the middle ear such as the retro- and hypotympanum [1–3]. These technical refinements allow the surgeon to treat middle-ear pathologies adopting a minimally invasive transcanal approach without skin incision or removal of bone for access purposes.…”

Section: Introductionmentioning

confidence: 99%

Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques

et al. 2019

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Background Endoscopic ear surgery is gaining increasing popularity and has an important impact on teaching middle ear anatomy and basic surgical skills among residents and fellows. Due to the wide-angled views offered, the approach significantly differs from the established microscopic technique. This randomized study compares the acquisition of basic ear-surgery skills using the endoscopic and microscopic technique under standardized conditions. We aim to investigate the required surgical times, attempts and accidental damages to surrounding structures (errors) in surgeons with different training levels. Methods Final-year medical students (n = 9), residents (n = 14) and consultants (n = 10) from the Department of Otorhinolaryngology, Head and Neck Surgery at the University Hospital of Bern, Switzerland were enrolled in the present study. After randomization every participant had to complete a standard set of grasping and dissecting surgical tasks in a temporal bone model. After the first session the participants were crossed over to the other technique. Results Time required for completion of the surgical tasks was similar for both techniques, but highly dependent on the training status. A significant increase in the number of damages to the ossicular chain was observed with the microscopic as compared to the endoscopic technique (p < 0.001). Moreover, students beginning with the endoscopic technique showed an overall significantly lower amount of time to complete the tasks (p = 0.04). From the subjective feedback a preference towards the endoscopic technique mainly in medical students was observed. Conclusions The endoscopic approach is useful and beneficial for teaching basic surgical skills, mainly by providing a reduction of damage to surrounding tissues with similar operating times for both techniques. Moreover, medical students performed significantly faster, when first taught in the endoscopic technique. Especially for young surgeons without previous training in ear surgery, the endoscope should be considered to improve surgical skills in the middle ear.

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Section: Introductionmentioning

confidence: 99%

Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques

et al. 2019

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“…The anatomy of the middle ear is particularly complex and challenging (Marchioni et al, ). The hidden recesses of the retrotympanum are difficult to explore, and therefore, are poorly understood (Marchioni et al, ; Bonali et al, ; Alicandri‐Ciufelli et al, ). Conditions affecting the middle ear, such as acute otitis media, transmissive hearing loss, chronic inflammation with or without cholesteatoma or ear drum perforations, are frequent among all age groups.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study

Anschuetz

Huwendiek

Stricker

et al. 2018

Anatomical Sciences Ed

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Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear's highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope-and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2-4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes. Anat Sci Educ 12: 507-517.

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“…ndoscopic ear surgery (EES) is gaining popularity among ear surgeons because it permits minimally invasive and functional surgery. Advantages of the endoscopic technique include (1) panoramic views of middle ear anatomy, 1 especially of the retrotympanum and hypotympanum [2][3][4] ; (2) enhanced magnification of very small anatomic structures, such as, a malformed stapes 5 ; (3) the possibility to use angled endoscopes 6 ; (4) preservation of healthy mastoid and middle ear mucosa 7 ; and (5) possible shorter operating times. 8 However, the endoscopic technique has its inherent challenges: (1) because it is a 1-handed technique, the learning curve is deemed to be slower and management of bleeding may be challenging, 9 (2) the narrow space available in the external auditory canal (EAC) limits the movements of surgical instruments, (3) disease inside the mastoid may not be addressed, and (4) until recently, high-definition camera systems were exclusively 2-dimensional (2D).…”

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confidence: 99%

Comparison of 3- vs 2-Dimensional Endoscopy Using Eye Tracking and Assessment of Cognitive Load Among Surgeons Performing Endoscopic Ear Surgery

Anschuetz

Niederhauser

Wimmer

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Endoscopic ear surgery (EES) is an emerging technique to treat middle ear diseases; however, the interventions are performed in 2-dimensional (2D) endoscopic views, which do not provide depth perception. Recent technical developments now allow the application of 3-dimensional (3D) endoscopy in EES. OBJECTIVE To investigate the usability, advantages, and disadvantages of 3D vs 2D endoscopy in EES under standardized conditions. DESIGN, SETTING, AND PARTICIPANTS This cohort study conducted at a tertiary academic medical center in Bern, Switzerland, included 16 residents and consultants of the

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Facial sinus endoscopic evaluation, radiologic assessment, and classification

Abstract: NA. Laryngoscope, 128:2397-2402, 2018.

Cited by 29 publications

References 20 publications

Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques

Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques

Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study

Comparison of 3- vs 2-Dimensional Endoscopy Using Eye Tracking and Assessment of Cognitive Load Among Surgeons Performing Endoscopic Ear Surgery

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