Rationale for Endoscopic Ear Surgery

In clear contrast to the impact of the introduction of endoscope in most surgical disciplines, the practice of ear surgery has changed little and it continues to be the domain for the microscope. Depending on the task at hand, there are many distinctions that would make the endoscope a better instrument than the microscope and vice versa. We all need to master working with both instruments to better understand and treat pathologies of the ear. The objective of this group and this web site is to neutralize these longstanding biases toward the microscope and to get all of us to use the best instrument in the best way possible to help our patients.

The ability to place the surgeons eyes within the ear cavity using angled endoscopes, allows the operator a contextual understanding of the anatomy that is difficult to match using the microscope.  The disease/ anatomical interface is better appreciated.  This improved anatomical understanding, in turn provides confidence in surgical procedures both endoscopically and microscopically.

When compared to the microscope, two distinct advantages are present with the endoscope.

  1. The Objective lens is placed within the ear canal or middle ear, which allows for an all-encompassing contextual view of the disease/ anatomy interface.  In contrast, the traditional microscopic method relies on removal of significant amounts of normal bone and soft tissue, often with removal of intact structures to fully observe the disease extent.
  2. The live image used by the surgeon is the same one that everyone else in the operating room is observing. This simultaneous viewing significantly increases engagement, teaching opportunities and interest in the surgical procedure from all present in the OR.
enscopic ear surgery field of view

The use of the endoscope enables the surgeon to visualize past the shaft of larger surgical instruments, such as drills and curettes, and allows better visualization of anatomical structures.

 

To view the up to date research on Endoscopic Ear Surgery, please visit the link below.

RSS endoscopy ear

  • Oral Corticosteroids Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis Without Nasal Polyposis: A Randomized Clinical Trial March 4, 2021
    CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of patients with CRS without polyps, oral prednisone following ESS conferred no additional benefit over placebo in terms of SNOT-22 total scores, SNOT-22 rhinologic subscores, or Lund-Kennedy endoscopy scores up to 6 months after surgery. Patients receiving prednisone, however, did demonstrate worse SNOT-22 psychologic subdomain scores. These […]
    Michael T Chang
  • An Unusual Retained Choanal Foreign Body: A Possible Complication of COVID-19 Testing With Nasopharyngeal Swab February 26, 2021
    Testing for coronavirus disease 2019 is critical in controlling the pandemic all over the world. Diagnosis of severe acute respiratory syndrome coronavirus-2 infection is based on real-time polymerase chain reaction performed on nasopharyngeal swab. If not adequately performed, the viral specimen collection can be painful and lead to complications. We present a complication occurred during […]
    Michele Gaffuri
  • SARS-CoV-2 Nasopharyngeal Swab as a Foreign Body: A Case Report February 22, 2021
    The SARS-CoV-2 pandemic response utilizes nasopharyngeal swabbing as a prolific testing method for presence of viral RNA. The depth of the swab to the nasopharynx coupled with breakpoints along the shaft leads to a risk for foreign body retention. Here, we present a case of a nasopharyngeal swab that became a retained foreign body during […]
    Madelyn N Stevens
  • Aerosol generation during routine rhinologic surgeries and in-office procedures February 22, 2021
    CONCLUSION: Use of a surgical mask over the patient's mouth during in-office procedures or a mask with a slit for an endoscope during RNE significantly diminished aerosol generation. However, whether this reduction in aerosol generation is sufficient to prevent transmission of communicable diseases via aerosols was beyond the scope of this study. There were several […]
    Dhruv Sharma
  • Superiorly based subperiosteal orbital abscess: an uncommon presentation February 19, 2021
    A 32-year-old female patient presented with severe facial pain, right eye proptosis and diplopia. Endoscopy revealed ipsilateral crusting, purulent discharge and bilateral nasal polyps. Imaging demonstrated a subperiosteal abscess on the roof of the right orbit. Due to patient's significant ocular manifestations, surgical management was decided. The abscess was drained using combined endoscopic and external […]
    Georgios Chrysovitsiotis
  • Ultrasonography of the larynx: Novel use during the SARS-CoV-2 pandemic (Review) February 19, 2021
    Few articles have been published on the subject of laryngeal ultrasonography. However, considering the increased power and accuracy of ultrasound technology, this imaging modality should be reevaluated. The present review aimed to increase the awareness of fellow specialists regarding the use of this imaging tool in healthcare units that do not benefit from onsite ear, […]
    Romica Cergan
  • Peritonsillar abscess drainage: using oropharyngeal endoscopy as a therapeutic adjunct and training tool February 18, 2021
    BACKGROUND: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage.
    A Sawhney
  • Types of Transnasal Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma: Shanghai EENT Hospital Experience February 15, 2021
    CONCLUSIONS: The result of TEN in the treatment of rNPC is promising. The types of TEN will provide effective guideline for surgical treatment of rNPC.
    Quan Liu
  • Patients and experiences from the first Danish flavour clinic February 12, 2021
    CONCLUSIONS: An accurate distinction between smell and taste requires application of validated chemosensory tests and specialised knowledge. As this is not readily available in all ENT clinics, sensory loss without a clear aetiology should be referred to a more specialisedcentre.
    Alexander Fjaeldstad
  • Endoscopy during neurotomy of the nervus intermedius for nervus intermedius neuralgia: a case report February 11, 2021
    Nervus intermedius neuralgia (NIN) is a rare craniofacial neuralgia with features of paroxysmal pain in the deep ear. Because of sensory nerves overlap in the ear, the diagnosis of NIN is often difficult and not definitive. Here, we present the case of a 70-year-old woman who had deep-ear pain for more than 4 years and […]
    Zhuhuan Song