An overview of endoscopic ear surgery in 2018

Abstract

Objective To provide an overview of Endoscopic Ear Surgery, its development, principles, and penetration in otology practice in 2018. Data Source PubMed review of literature and cross‐sectional email survey of otologists. Methods We reviewed all PubMed published articles on use of endoscopy in practice of otology over the last 50 years. Articles were categorized based on date of publication and pattern of utilizing the endoscope. We also conducted two identical email surveys in 2010 and 2018 of otologists on the use of endoscope and tabulated and compared results. Results The number of publications on use of endoscope has increased from 6 in 1990 to an accumulated total of 451 in 2018. There has been a clear shift in the area of interest away from diagnostic endoscopy, to endoscope‐assisted surgery, and lately, to transcanal endoscopic ear surgery (TEES). Survey results further documented the increased awareness of the value of the endoscope and its increased use in clinical practice. Conclusion TEES has gained traction as a subject of research interest and in clinical practice and has lately dominated the discussion on the use of endoscope in otology. Level of Evidence NA

Heads-up Surgery

“…In otology and neurotology, endoscopes have advanced from an observational instrument (“otoendoscopy”) to an operative one (“endoscopic ear surgery” or EES) at a growing number of centers. Although there has been a rapid increase in the adoption of EES within the last decade, 3 the endoscope continues to generate debate amongst surgeons as a primary modality for performing middle ear surgery. Interestingly, many of the arguments raised against EES match those made by rhinologists when the Hopkins rod telescope was introduced for sinus surgery.…”

“…Importantly, this reduces the need for soft tissue retraction and bony dissection. 3 Finally, mastoidectomy is an aerosol generating procedure (AGP) 9 , 10 and surgical aerosols can carry viral pathogens. 11 Endoscopes play an important role in risk mitigation during the era of the COVID-19 pandemic, reducing the need for mastoidectomy.…”

“…Transcanal endoscopic ear surgery (TEES) is an ideal approach for the management of cholesteatoma, as the pathology can be followed along the anatomical growth pattern from the tympanic membrane to the tympanic cavity and hidden recesses. 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.…”

Self-Expandable Retainer for Endoscopic Visualization in the External Auditory Canal: Proof of Concept in Human Cadavers

“…The past three decades have witnessed a growth in the use of endoscopy and it is used in several surgical disciplines including otologic surgery [1]. Endoscopic ear surgery (EES) has several advantages over conventional surgical microscopy.…”

The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not

“…6 Endoscopic surgery has the benefits of a wide field of vision, minimal trauma and a short operation time without the bone removal and with less blood loss than in myringoplasty, attic cholesteatoma surgery, stapes surgery, second-look tympanotomy and reconstruction of ossicles surgery. [7][8][9] These benefits make endoscopic surgery especially suitable for middle-and inner-ear surgery. The myringoplasty in this study was performed under endoscopy.…”