Surgical results of transcanal endoscopic ear surgery in chronic otitis media.

Abstract

Learning Objectives:Patulous eustachian tube (PET) can have a significant negative impact on a patient's quality of life. Several methods of surgical management can be an option to treat PET, and our objective is to evaluate the safety and efficacy of autologous cartilage injection in patients with PET. Thirty-three ears of twenty-five patients with chronic PET refractory to conservative treatment were enrolled to this study. Autologous tragal cartilage was harvested, and chopped into fine pieces to allow its injection using a 1cc Bruening syringe. Endoscopic cartilage injection was performed submucosally into the anterior (0.5 mL) and posterior aspects (0.5 mL) of the nasopharyngeal ET under local anesthesia in an operating room. Patients were evaluated postoperatively by nasal endoscopy and by interview to document symptoms. Successful treatment was defined as complete relief or significant improvement plus satisfaction with treatment. The only complication that occurred was temporary otitis media with effusion in one ear. Inferior turbinate reduction was performed in three ears with accompanying nasal septal deviation or turbinate hypertrophy to allow better nasopharyngeal ET visualization. After autologous cartilage injection, the successful treatment rate, as determined by subjective autophony symptoms, was 69.7% (23/33). The average follow-up period was 25.2 months. Autologous cartilage injection is a minimally invasive technique that has been used by the authors to successfully treat patulous eustachian tube. The described procedure was found to provide a good overall success rate without long-term complications.doi:10.1017/S0022215116006551 ID: IP159Surgical results of transcanal endoscopic ear surgery in chronic otitis media. Presenting Author: Masafumi OhkiMasafumi Ohki, Masatoshi Takashima, Yuka Kitano, Atsushi Tahara, Sunao Tanaka, Tsutomu Nomura, Atsushi Ohata, Shigeru Kikuchi Saitama Medical Center Learning Objectives: To endoscopically examine surgical results for chronic otitis media after endoscopical ear surgery comparing with mocroscopic ear surgery Introduction: Middle ear surgery has commonly been treated using a surgical microscope. A binocular stereomicroscope has often been used in ear surgery because this instrument offers many advantages including binocular stereoscopic vision of the surgical field; no obstruction of the view by blood, mucus, or bone dust on the lens; high magnification, besides being hands-free. Conversely, the narrow-angle view is a disadvantage of using a microscope for middle ear surgery. Moreover, there are several blind areas behind important structures, such as the facial nerve, that cannot