Endoscopic tympanoplasty

Abstract

Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.

Investigating the learning curve in endoscopic compared to microscopic myringotomy and ventilation tube insertion

“…Traditionally, the microscope has been the ‘gold standard’ for middle-ear surgery, 1–3 but improvements in technology, such as fibre-optics and high-definition video, have made the endoscope a viable alternative. 1…”

How do you perform your tympanoplasty, endoscopically or microscopically?

“…ET also does not necessitate postauricular incision, which means better postoperative cosmetic results including no postauricular scar, auricular deformity or pinna asymmetry. [3,12,21] CMT requires more postoperative care such as a compression bandage for a postauricular incision, which causes a later return to routine daily activity than in ET. [22] Postoperative pain and complications such as wound dehiscence or infection were reported to be significantly lower in ET than CMT.…”

Türk İş Hukukunda Avrupa Birliği Yönergeleri Çerçevesinde Denkleştirme Uygulaması

“…Denkleştirme, işçinin iş sözleşmesi ile normal haftalık çalışma süresinin tarafların yapacağı anlaşma ile ya da toplu iş sözleşmesi ile belli bir sürede günde on bir saati ve haftada altı günü aşmayacak şekilde belirli bir döneme işveren tarafından yayılması ve ortalama haftalık çalışma süresinin aşılıp aşılmadığının esas alındığı bir yöntemdir 42 . Buna göre, işçinin haftalık ortalama çalışma süresinin bazı haftalarda toplam kırk beş saati aşmasına imkân tanıyan denkleştirme uygulamasıyla, kırk beş saat üzeri çalışmaların karşılığı fazla çalışma ücreti olarak istenemeyecektir 43 Denkleştirme süresi, toplu iş sözleşmeleri ile dört aya kadar artırılabilir 49 .…”