Future of Endoscopic Ear Surgery

Nogueira, João Flávio; Querido, Raquel de Sousa Lobo Ferreira; Leite, Janaina Gonçalves da Silva; Costa, Ticiana Cabral da

doi:10.1016/j.otc.2020.09.023

Cited by 16 publications

(8 citation statements)

References 26 publications

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“…There are two main assisted instruments for tympanic membrane repair: otomicroscopy and otoendoscopy. Otoendoscopy-assisted tympanic membrane repair is superior to otomicroscopy-assisted in terms of intraoperative blood loss and operation time [ 14 ]. However, the otoendoscopy has the disadvantages of requiring one-handed operation, difficult operation, small space, easy to contaminate the lens, and low imaging quality.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Otomicroscopy Combined with Otoendoscopy Double-Lens Technology-Assisted Tympanic Membrane Repair on Elderly Patients with Chronic Suppurative Otitis Media

Cheng

Shao-hua

Wang

2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of otomicroscopy combined with otoendoscopy double-lens technology-assisted tympanic membrane repair on elderly patients chronic suppurative otitis media (CSOM). Methods. 120 elderly CSOM patients from January 2017 to July 2019 were selected and divided into the otomicroscopy group (n = 40), the otoendoscopy group (n = 40), and the double-lens group (n = 40) by the random number method. All patients were treated with tympanic membrane repair. The otomicroscopy group was assisted by otomicroscopy, the otoendoscopy group was assisted by otoendoscopy. and the double-lens group was assisted by otomicroscopy combined with otoendoscopy. The three groups of operations status, clinical efficacy, the incidence of adverse reactions, hearing improvement rate, and satisfaction rate with incision after 6 months were compared. Results. The operation time, intraoperative blood loss, hospitalization time, and VAS score of the otoendoscopy group and the double-lens group were all lower than those of the otoendoscopy group, and the operation time of the double-lens group was lower than that of the otoendoscopy group ( P < 0.05 ). The clinical efficacy of the double-lens group was better than that of the otomicroscopy group and otoendoscopy group ( P < 0.05 ). The adverse reaction rate of the otoendoscopy group and the double-lens group was lower than that of the otomicroscopy group, and the average postoperative air-bone conductance of the double-lens group was lower than that of the otomicroscopy group and the otoendoscopy group, and the hearing improvement rate was higher than that of the otomicroscopy and otoendoscopy groups ( P < 0.05 ). The satisfaction rate with postoperative incision in the otoendoscopy group and double-lens group was higher than that in the otomicroscopy group ( P < 0.05 ). Conclusion. The double-lens technology-assisted tympanic membrane repair has an obvious effect on elderly patients with CSOM. Compared with the single-use otomicroscopy, the operation time, intraoperative blood loss, hospitalization time, patient’s dry ear condition, degree of surgical pain, clinical efficacy, adverse reaction rate, hearing improvement rate, and patient’s incision satisfaction of the double-lens technology are better. Compared with the single-use otoendoscopy, the operation time, clinical efficacy, and hearing improvement rate of the double-lens technology are better.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Otomicroscopy Combined with Otoendoscopy Double-Lens Technology-Assisted Tympanic Membrane Repair on Elderly Patients with Chronic Suppurative Otitis Media

Cheng

Shao-hua

Wang

2021

Evidence-Based Complementary and Alternative Medicine

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“…There is debate regarding heat issues in endoscopic ear surgery, with a limited body of work documenting potential negative impacts of middle-ear heat exposure from endoscopes [ 13 ]. Nogueira et al [ 14 ] stated that the middle ear cavity is small and to have a great view the surgeon needs no more than 40% of light power. Moreover, Mitchell and Coulson [ 13 ] recommended that continuous exposure of the endoscope to the middle ear, in the absence of any cooling mechanism, should be limited and, ideally, should not exceed 5 min.…”

Section: Discussionmentioning

confidence: 99%

Chorda tympani injury during endoscopic versus microscopic stapes surgery: a randomized controlled clinical trial

Moneir

Eladl

El-Okda

et al. 2022

Eur Arch Otorhinolaryngol

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Objectives The aim of this study was to compare the incidence of chorda tympani nerve (CTN) injury between endoscopic and microscopic stapes surgery. Methods This randomized controlled clinical trial included 88 patients who were randomly divided into two groups: endoscopic stapedotomy group (n = 44) and microscopic stapedotomy group (n = 44). The incidence of chorda tympani nerve (CTN) injury after surgery was determined by both subjective taste testing and chemical taste tests, before and after surgery. The results were compared between the two groups. Results The total number of patients who were identified as having CTN affection (based on the chemical testing) was 16 out of 88 (18.2%). The incidence was significantly lower in the endoscopic group (n = 2) than the microscopic group (n = 14) (p = 0.019). Conclusion Altered taste as a result of iatrogenic CTN injury can affect the patients’ quality of life. Endoscopic ear surgery offers better visualization, less need for extensive manipulation of the chorda tympani, and consequently decreased incidence of CTN injury.

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“…Dies beruht offensichtlich in erster Linie auf der Implementierung dieser Operationsmethode an Universitätskliniken, aber auch nichtuniversitäre Einrichtungen sind sehr aktiv beteiligt. Insbesondere die aktuellere Literatur und der steile Anstieg der Anzahl an internationalen Publikationen der letzten 5 Jahre zu diesem Thema unterstreicht das hohe Potenzial der endoskopischen Ohrchirurgie [ 7 , 21 , 23 , 24 , 31 , 37 ]. Die hier vorstellte Fragebogenerhebung hatte das ausschließliche Ziel, einen Überblick über den aktuellen Einsatz der EES in Deutschland zu geben.…”

Section: Diskussionunclassified

Endoskopische Ohrchirurgie in Deutschland

Agha-Mir-Salim

Kropp

Müller

2021

HNO

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Zusammenfassung Hintergrund International hat sich die endoskopische Ohrchirurgie („endoscopic ear surgery“, EES) fest etabliert. In Deutschland wird sie kontrovers diskutiert und unterschiedlich angewendet. Daher erfolgte eine Umfrage zu Angebot, Indikationen, Kontraindikationen und zum zukünftigen Stellenwert der EES. Methodik An 141 deutsche Universitäts- und Hauptabteilungen für HNO-Heilkunde, Kopf- und Halschirurgie wurde ein Fragebogen mit 20 Fragen versendet. Die Ergebnisse wurden anhand aktueller Literatur gemäß Suche in PubMed und Google Scholar erörtert. Ergebnisse Der Umfragerücklauf betrug 32 % (45 Kliniken). Die EES meist flankierend durchzuführen, gaben 27 Kliniken (60 % der Antwortenden) an. Nur eine Klinik führte alle Ohreingriffe ausschließlich endoskopisch durch. Bei Auftreten intraoperativer Blutungen, Bohrarbeiten am Mastoid oder bei Notwendigkeit bimanuellen Arbeitens wurde zur mikroskopischen Technik („microscopic ear surgery“, MES) gewechselt. Als häufigste Indikationen für die EES wurden Tympanoskopie, Cholesteatom, Retraktionstasche, Eingriffe am Trommelfell und am Gehörgang angegeben. Der Aufwand bei der EES wurde in rund 50 % aller Antworten höher als in der MES eingeschätzt. Bei den EES-Kliniken dominierte mit 78 % der Tragusknorpel als rekonstruktives Transplantat. Nur 4 von 45 antwortenden Kliniken schätzten den zukünftigen Stellenwert der EES in Deutschland als hoch ein. Schlussfolgerung Die EES wird in Deutschland zwar eingesetzt, jedoch nur in wenigen HNO-Kliniken in größerem Umfang angewendet. Als problematisch gelten das einhändige Arbeiten, die Durchführung von Bohrarbeiten, Beherrschung von Blutungen und der insgesamt als höher eingeschätzte Aufwand. Häufig wird deshalb die EES flankierend am Ohr angewendet und zwischen EES und MES gewechselt.

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Future of Endoscopic Ear Surgery

Cited by 16 publications

References 26 publications

Efficacy of Otomicroscopy Combined with Otoendoscopy Double-Lens Technology-Assisted Tympanic Membrane Repair on Elderly Patients with Chronic Suppurative Otitis Media

Efficacy of Otomicroscopy Combined with Otoendoscopy Double-Lens Technology-Assisted Tympanic Membrane Repair on Elderly Patients with Chronic Suppurative Otitis Media

Chorda tympani injury during endoscopic versus microscopic stapes surgery: a randomized controlled clinical trial

Endoskopische Ohrchirurgie in Deutschland

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