The anatomic applicability of transcanal endoscopic ear surgery in children

Sun, Wan‐Hsuan; Kuo, Chin‐Lung; Huang, Tzu-Chin

doi:10.1016/j.ijporl.2017.12.016

Cited by 16 publications

(7 citation statements)

References 19 publications

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“…The clinical significance of OME is often overlooked and very few studies have explored this condition in depth, despite the fact that it is commonly associated with CLP. The author summarizes and updates his previous work with the article partly borrowing from the author's earlier publications [4,[9][10][11][12][13][14][15][16][17][18][19][20][21]. This paper presents a review of the pathogenesis, clinical manifestations, and diagnoses of OME in children with CLP as well as the controversies surrounding treatment.…”

Section: Introductionmentioning

confidence: 99%

Glue Ear in Children with Cleft Lip and Palate: An Update

Kuo¹

2018

CMT

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Cleft lip/palate (CLP) in children is psychologically stressful for family members and debilitating for the patients themselves. These children must undergo a series of major invasive surgeries, including cleft lip repair surgery, cleft palate repair surgery, bone grafting surgery, and/or dental implant surgery. Unfortunately, the clinical significance of otitis media with effusion (OME), a complication associated with CLP, is often overlooked and very few studies have explored this condition in depth. In this paper, the author reviews the pathogenesis, clinical manifestations, and diagnoses of OME in children with CLP as well as the controversies surrounding treatment. We also provide a flowchart to guide the management of OME in children with CLP.

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Section: Introductionmentioning

confidence: 99%

Glue Ear in Children with Cleft Lip and Palate: An Update

Kuo¹

2018

CMT

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“… 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. Additionally, the more acute angle of the EAC relative to the tympanic membrane in children presents another anatomic challenge, as this can interfere with visualization of the epitympanum and the retrotympanum for both microscopes and 0° endoscopes.…”

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.…”

Section: Discussionmentioning

confidence: 99%

Current trends and applications in endoscopy for otology and neurotology

Ridge

Shetty

Lee

2021

World j. otorhinolaryngol.-head neck surg.

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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.

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“…Ito et al reported that the mean diameter of the narrowest region of the EAC, in pediatric patients who underwent a successful TEES operation using a 2.7 mm endoscope, was 5.0 ± 1.0 mm (23). Wan-Shuan et al reported over 84% of pediatric external ear anatomy is suitable for TEES using a 3 mm endoscope and 1 mm diameter instruments (24). Although the SFT shaft is wider, at 1.65 mm, the ability to adjust the curvature and length of the steerable tip allows effective maneuvering in the middle ear, around the endoscope, even without recourse to canalplasty.…”

Section: Discussionmentioning

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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The anatomic applicability of transcanal endoscopic ear surgery in children

Cited by 16 publications

References 19 publications

Glue Ear in Children with Cleft Lip and Palate: An Update

Glue Ear in Children with Cleft Lip and Palate: An Update

Current trends and applications in endoscopy for otology and neurotology

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

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