Surgical anatomy of transcanal endoscopic approach to the tympanic facial nerve

Marchioni, Daniele; Alicandri‐Ciufelli, Matteo; Piccinini, Alessia; Genovese, Elisabetta; Monzani, Daniele; Tarabichi, Muaaz; Presutti, Livio

doi:10.1002/lary.21819

Cited by 44 publications

(40 citation statements)

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“…Magnification of the tympanic cavity anatomy [14] and good knowledge of middle ear structures [15] allow a minimally invasive approach for removal of the disease. In this report, we have described the first facial hemangioma treated with an endoscopic transcanal approach, combined with a retroauricular mastoidectomy and minicraniotomy on the temporalis squama, to insert a dural plastic patch and great auricular nerve graft of interrupted nerve segments.…”

Section: Discussionmentioning

confidence: 99%

Facial nerve hemangioma of the geniculate ganglion: An endoscopic surgical approach

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Facial nerve hemangioma of the geniculate ganglion: An endoscopic surgical approach

et al. 2014

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“…Similarly, the number of papers reporting the advantages of endoscopic middle ear visualization has also been increasing in the last years [6][7][8][9] . Despite improvements, especially in terms of lighting and magnification, microscopes have defined lines of sight and are constrained by the anatomy of the external auditory canal leading to areas within the surgical field that are difficult, if not impossible, to visualize [9][10][11][12] . With endoscopes, the line of sight can be moved closer to the surgical field, allowing more complete surveillance.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic vs Microscopic Approach in Stapes Surgery: Advantages in the Middle Ear Structures Visualization and Trainee's Point of View

Iannella

Marcotullio²,

Re³

et al. 2017

Int Adv Otol

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OBJECTIVE:Comparing the endoscopic and microscopic approaches in stapes surgery, and establishing the surgical approach that allows better results in terms of visualization of the middle ear structures and aids assistant's training. MATERIALS and METHODS:Twenty-one residents from the first to the fifth year of training in Otolaryngology were enrolled in this prospective study. A questionnaire specifically designed to investigate the understanding of middle ear anatomy, the surgical steps, and a personal opinion about endoscopic stapes surgery was submitted to each resident. RESULTS:Statistical differences between the endoscopic and microscopic approaches were evident about identification of stapes and long process of the incus (p=0.03) and stapes footplate and the oval window (p=0.03). No substantial difference between the two surgical approaches emerged regarding the visualization of the tympanic membrane and the other middle ear structures (p>0.5). A substantial difference in favor of the endoscopic approach emerged regarding the identification of the hole creation in the footplate of the stapes. CONCLUSION:Endoscopic stapes surgery could favor an easier understanding of the surgical technique for assistants in training with little knowledge of the anatomy and surgical steps.

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“…Endoscopy has increasing role to play in the ear surgery, namely photo documentation of tympanic membrane [5], cholesteatoma surgery [6], surgery of the facial nerve [7], and anatomy of the sinus tympani [8]. Endoscope assistance has improved the visual exposure of hidden and deep structures, it provides a wide angle view of the tympanic membrane remnant and middle ear structures.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study Comparing the Results of Endoscope Assisted Versus Microscope Assisted Myringoplasty

Ahmed¹

2016

GJO

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Objective: To assess the operative time, post operative pain, graft uptake and audiological gain in the group of the patients undergoing the endoscope assisted and the microscope assisted myringoplasty. Setting: Tertiary referral hospital. Subjects:The study was prospective in nature and comprised of 100 patients suffering from the chronic otitis media inactive mucosal disease. Patients attending the Otorhinolaryngology out patients department were included in this study. Methods:Transcanal myringoplasty or type-1 tympanoplasty was performed by either the endoscope or the microscope assistance. Endaural/Postaural approach was undertaken in few microscope assisted myringoplasty. Underlay technique of myringoplasty was performed using temporalis fascia graft in all the patients suffering from the inactive mucosal chronic otitis media. Post operative evaluation was done in terms of operative time, pain, graft uptake and audiological gain. The patients were followed up for a period of 6 months. Results:The operative time in the patients undergoing the endoscope assisted myringoplasty was 49.76±3.18 minutes whereas it was 62.37±3.69 minutes in the patients undergoing the microscope assisted Transcanal myringoplasty and 72.15±2.56 minutes in the patients undergoing the microscope assisted Endaural/Postaural myringoplasty. Post operative pain was assessed the next day after the surgery, it was less severe in the Transcanal approach endoscope/microscope assisted myringoplasty groups and more severe in the microscope assisted Endaural/Postaural approach myringoplasty group. The difference between the groups was statistically significant. The tympanic membrane graft uptake and audiological gain was assessed at 1 month, 3months and 6 months post operatively. The successful closure of the tympanic membrane perforation was higher with the endoscope assisted myringoplasty as compared to the microscope assisted myringoplasty at 1 month, 3 months and 6 months of follow up but the difference was not statistically significant. The mean audiological gain following myringoplasty with both the techniques used was noted. The mean audiological gain was found to be marginally better with the endoscope assisted myringoplasty at follow up of 1, 3 and 6 months as compared to the microscope assisted myringoplasty, however this difference was not statistically significant. Conclusion:The operative time was less in the endoscope assisted technique as compared to the microscope assisted technique. The post operative morbidity (evaluated in terms of post operative pain) was less in the group of patients undergoing the Transcanal endoscope assisted as compared to microscope assisted myringoplasty. The post operative pain was more severe in the Endaural/Postaural approach than the Transcanal approach microscope assisted myringoplasty. There was no statistically significant difference in either graft uptake or post-operative audiological gain in the patients undergoing myringoplasty by endoscope assisted and microscope assisted technique....

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Surgical anatomy of transcanal endoscopic approach to the tympanic facial nerve

Abstract: The tympanic facial nerve can be thoroughly visualized by an exclusive endoscopic transcanal approach, even in poorly accessible regions such as the second genu and geniculate ganglion. Further clinically based reports may strengthen our preliminary results.

Cited by 44 publications

References 11 publications

Facial nerve hemangioma of the geniculate ganglion: An endoscopic surgical approach

Facial nerve hemangioma of the geniculate ganglion: An endoscopic surgical approach

Endoscopic vs Microscopic Approach in Stapes Surgery: Advantages in the Middle Ear Structures Visualization and Trainee's Point of View

A Prospective Study Comparing the Results of Endoscope Assisted Versus Microscope Assisted Myringoplasty

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