Endoscope Affects Decision Making in Cholesteatoma Surgery

El-Meselaty, K.; Badr-El-Dine, Mohamed; Mandour, Mohamed; Mourad, Mohamed I.; Darweesh, Reda M.A.

doi:10.1016/s0194-59980301577-8

Cited by 19 publications

(1 citation statement)

References 14 publications

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“…Endoscopy has certainly paved the way for a better understanding of the middle ear anatomy and pathology development. Currently, the indications of endoscopic middle ear surgery are gradually being increased in replacement of or addition to the traditional microscopic techniques (19)(20)(21)(22). The expansion of the endoscopic application to lateral skull base surgery has been the natural consequence of the extensive experience gained from endoscopic middle ear surgery and advances in specialized instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Topographic Anatomy of the Medial Labyrinthine Wall: Implications for the Transcanal Endoscopic Approach to the Internal Auditory Canal

Yacoub¹,

Molinari²,

Mostafa

et al. 2022

Otology &Amp; Neurotology

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HypothesisTo characterize transcanal endoscopic landmarks of the medial labyrinthine wall and correlate these with anatomical features of the fundus of the internal auditory canal (IAC).BackgroundThe transcanal transpromontorial approach (TTA) enables minimally invasive access to the IAC. The establishment of a landmark-based dissection technique for the approach is crucial to avoid injury to the facial nerve.MethodsTwenty temporal bones were dissected endoscopically through the TTA. Furthermore, high-resolution computed tomography (CT) scans from ten adult normal temporal bones were analyzed and three-dimensionally reconstructed.ResultsA stepwise dissection technique for the TTA was demonstrated depending on a newly described landmark used in the identification of the facial nerve. The proposed landmark, which was named the intervestibulocochlear crest (IVCC), is an integrated part of the otic capsule. It can be differentiated after the excision of the lateral labyrinthine wall as a laterally based bony pyramid between the cochlea and the vestibule. Its medially directed apex blends with the central part of the falcifrom crest and points to the distal part of the meatal facial nerve. The IVCC is best detected on axial CT images at the level of the tympanic facial nerve. The union between the IVCC and the falciform crest appears radiologically as a short stem or mini-martini glass.ConclusionThe proposed IVCC is a novel landmark with a consistent relationship to the IAC fundus and the facial nerve. It may be utilized in conjunction with the falciform crest to identify the facial nerve during minimally invasive transcanal surgeries.

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Section: Discussionmentioning

confidence: 99%

Topographic Anatomy of the Medial Labyrinthine Wall: Implications for the Transcanal Endoscopic Approach to the Internal Auditory Canal

Yacoub¹,

Molinari²,

Mostafa

et al. 2022

Otology &Amp; Neurotology

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Pyramidal eminence and subpyramidal space: An endoscopic anatomical study

et al. 2009

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Systematic review of outcomes following observational and operative endoscopic middle ear surgery

et al. 2014

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Objective Middle ear surgery increasingly employs endoscopes as an adjunct to or replacement for the operative microscope. Superior visualization and transcanal access to disease normally managed with a transmastoid approach are touted as advantages with the endoscope. No study, however, has systemically reviewed the literature to evaluate outcomes of endoscopic ear surgery (EES). We provide a systematic review of endoscope applications in middle ear surgery with an emphasis on outcomes. Data Sources PubMed, Embase, and Cochrane Methods A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. Articles were categorized based on study design, indication, and use of an endoscope either as an adjunct to or as a replacement for a microscope. Quantitative and descriptive analyses were performed. Results Ninety-one articles published between 1967 and 2014 met inclusion and exclusion criteria. The main indication for the use of an endoscope was cholesteatoma or myringoplasty. Of the identified articles, 40 provided a discrete discussion of outcomes. In cholesteatoma surgery, the endoscope has been mainly employed as an adjunct to the microscope, and although outcomes assessments vary across studies, the endoscope identified residual cholesteatoma in up to 50% of cases. Conclusion Endoscopes have been predominately used as an observational adjunct to the microscope to improve visualization of the tympanic cavity. Recent reports utilize the endoscope exclusively during surgical dissection; however, data comparing patient outcomes following the use of an operative endoscope versus a microscope are lacking. Areas in need of additional research are highlighted.

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Endoscope Affects Decision Making in Cholesteatoma Surgery

Cited by 19 publications

References 14 publications

Topographic Anatomy of the Medial Labyrinthine Wall: Implications for the Transcanal Endoscopic Approach to the Internal Auditory Canal

Topographic Anatomy of the Medial Labyrinthine Wall: Implications for the Transcanal Endoscopic Approach to the Internal Auditory Canal

Pyramidal eminence and subpyramidal space: An endoscopic anatomical study

Systematic review of outcomes following observational and operative endoscopic middle ear surgery

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