A New Optical System in Tympanic Membrane and Middle Ear Endoscopy

Abstract

In cooperation with the firm of Richard Wolf, a new ear telescope has been developed which facilitates the diagnosis and documentation of tympanic membrane lesions. This 6.8 mm telescope of the Lumina type is prevented from misting up by a stream of air directed across the distal viewing window. This 6.8 mm Lumina telescope also formed the basis for a completely newly developed optical system for middle ear endoscopy. This combined optical system comprising a mother and baby scope has been undergoing trials for the past 18 months. The baby scope can be passed through the mother scope, thus permitting inspection of the tympanic cavity, under direct vision and unaffected by involuntary movements of the patients. The particular configuration of this system makes it easy for the endoscopist to apply his eye first to one and then to the other telescope. The 6.8 mm mother scope and the 2.7 mm baby scope can both be connected to a camera which provides high-quality pictures the dimension of which are only a little smaller than those of a slide.

Functional Endoscopic Tympanic Surgery Anatomical Bases

“…Considering the evolution of the endoscopic middle ear surgery over the last four decades through hundreds of published researches, tens of books and many courses and conferences, the concept has passed from a diagnostic tool to a secondary complimentary tool or step to a complete surgical approach. [1][2][3][4][5][6] However, until today the principle of incorporating endoscopes in the middle ear surgery was focusing mainly on the "approach" and most of efforts were to change the traditional microscopic surgery or combined microscopic and endoscopic surgery for disease eradication and / or hearing restoration into pure endoscopic approached surgery. Although, it is become well known, for over four hundred years since Bartholomeo Eustachi in 1576 has corrected the description of the Eustachian tube, that many of the middle ear diseases are result of ventilation problem and a lot of work have been done to describe treatment for the Eustachian tube dysfunction, the idea of developing a distinctive type of functional endoscopic middle ear surgery to treat the middle ear ventilation problems is not well established yet.…”

Water used to visualize and remove hidden foreign bodies from the external ear canal

“…Due to the curve of the external ear canal, the tympanic sulcus is often out of sight (DeWeese and Saunders, 1977;Donaldson and Miller, 1980). Small endoscopes (Eichner, 1981;Hawke, 1982;Yangisawa and Carlson, 1987) and micromirrors (Lundborg and Linzander, 1970;Gonzalez and Bluestone, 1986) have been used to visualize the entire tympanic membrane. Hidden foreign bodies can sometimes be removed by irrigation.…”