“… 3 A “scope holder” is not recommended as motion parallax creates a sense of depth perception. TEES diminishes the need for a canal wall up mastoidectomy in some cases 12 and facilitates en bloc removal of cholesteatoma, with an improved chance of ossicular preservation 13 and decreased rates of residual and recurrent disease. 14 In studies comparing TEES to microscopic surgery for cholesteatoma, results have shown comparable or improved rates of control, 15 improved quality of life, decreased surgical morbidity, shorter healing time, and less postoperative pain due to avoidance of postauricular incisions.…”
Synopsis
A new era of surgical visualization and magnification is poised to disrupt the field of otology and neurotology. The once revolutionary benefits of the binocular microscope are now shared with rigid endoscopes and exoscopes. These two modalities are complementary. The endoscope improves visualization of the hidden recesses through the external auditory canal or canal up mastoidectomy. The exoscope provides an immersive visual experience and superior ergonomics compared to binocular microscopy. Endoscopes and exoscopes are poised to disrupt the standard of care for surgical visualization and magnification in otology and neurotology.
“… 3 A “scope holder” is not recommended as motion parallax creates a sense of depth perception. TEES diminishes the need for a canal wall up mastoidectomy in some cases 12 and facilitates en bloc removal of cholesteatoma, with an improved chance of ossicular preservation 13 and decreased rates of residual and recurrent disease. 14 In studies comparing TEES to microscopic surgery for cholesteatoma, results have shown comparable or improved rates of control, 15 improved quality of life, decreased surgical morbidity, shorter healing time, and less postoperative pain due to avoidance of postauricular incisions.…”
Synopsis
A new era of surgical visualization and magnification is poised to disrupt the field of otology and neurotology. The once revolutionary benefits of the binocular microscope are now shared with rigid endoscopes and exoscopes. These two modalities are complementary. The endoscope improves visualization of the hidden recesses through the external auditory canal or canal up mastoidectomy. The exoscope provides an immersive visual experience and superior ergonomics compared to binocular microscopy. Endoscopes and exoscopes are poised to disrupt the standard of care for surgical visualization and magnification in otology and neurotology.
“… 1 Postauricular approaches require added soft tissue retraction and bony drilling which can lead to dysesthesia or anesthesia of the auricle, hypertrophic scars, keloids, or wound infection. 2 Figure 1 Anatomy illuminated by microscope versus endoscope. A: The size and shape of the external auditory canal and speculum limit the microscopic view.…”
Section: Discussionmentioning
confidence: 99%
“…However, the relative ratio of the endoscope diameter to that of the ear canal presents an additional anatomic challenge. 2 A 2017 study of CT scans from 40 pediatric subjects with a median age of 8.5 years found that the average pediatric EAC isthmus is 5.4 mm in diameter, as compared to 6.9 mm in adults, and that 84% of pediatric patients were able to undergo transcanal EES with a 3 mm endoscope. 14 For smaller ear canals, 2.7 mm and 1.9 mm scopes are available.…”
There has been a rapid increase in endoscopic ear surgery for the management of middle ear and lateral skull base disease in children and adults over the last decade. In this review paper, we discuss the current trends and applications of the endoscope in the field of otology and neurotology. Advantages of the endoscope include excellent ergonomics, compatibility with pediatric anatomy, and improved access to the middle ear through the external auditory canal. Transcanal endoscopic ear surgery has demonstrated comparable outcomes in the management of cholesteatoma, tympanic membrane perforations, and otosclerosis as compared to microscopic approaches, while utilizing less invasive surgical corridors and reducing the need for postauricular incisions. When a postauricular approach is required, the endoscopic-assisted transmastoid approach can avoid a canal wall down mastoidectomy in cases of cholesteatoma. The endoscope also has utility in treatment of superior canal dehiscence and various skull base lesions including glomus tumors, meningiomas, and vestibular schwannomas. Outside of the operating room, the endoscope can be used during examination of the outer and middle ear and for debridement of complex mastoid cavities. For these reasons, the endoscope is currently poised to transform the field of otology and neurotology.
“…These differences are graft preparation, tympanomeatal flap methods, graft insertion (underlay-overlay-inlay-butterfly-push through), tampons placed in the outer ear canal (EAC) and tragal area, etc. [1][2][3][4].…”
mentioning
confidence: 99%
“…The placement of the graft prepared after flap elevation differs according to surgeons [2]. At this stage, we place the perichondrial tragal graft for the right ear on the malleus (over) in the posterior, under the anulus in the anterior (under), and the outer ear canal in the lateral.…”
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