Endoscopic Techniques in Middle Ear Surgery
Summary
Endoscopic techniques in middle ear surgery have undergone rapid evolution over the past decade, driven by advances in optics, instrumentation and image-guided technology. By introducing rigid endoscopes through the external auditory canal, surgeons achieve high-definition panoramic views of the tympanic cavity and facial recess without resorting to post-auricular incisions or extensive canaloplasty. This transcanal approach has been applied successfully in tympanoplasty, myringoplasty, cholesteatoma clearance and stapedotomy, demonstrating comparable anatomical and audiological outcomes to traditional microscopic methods while reducing operative time and postoperative discomfort. Enhanced visualisation of hidden recesses facilitates precise disease removal and ossicular reconstruction, and minimally invasive access may decrease morbidity by preserving canal anatomy. Challenges remain in mastering one-handed dissection and overcoming a steep learning curve, but ongoing innovations in endoscope design and hands-free retraction continue to broaden the clinical horizon for middle ear endoscopy.
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Endoscopic Techniques in Middle Ear Surgery publication trend
The graph below shows the total number of articles in endoscopic techniques in middle ear surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Endoscopic transcanal ear surgery (TEES): A technique in which rigid endoscopes are inserted through the external auditory canal to visualise and operate within the middle ear using specialised micro-instruments.
Tympanoplasty: Reconstruction of the tympanic membrane and ossicular chain to restore sound conduction and middle ear integrity.
Myringoplasty: Surgical closure of a perforation in the tympanic membrane without ossicular chain reconstruction.
Stapedotomy: Creation of a small opening in the stapes footplate, usually for otosclerosis surgery, followed by prosthesis insertion to improve ossicular mobility.
References
- A retrospective comparative study of endoscopic and microscopic Tympanoplasty. Journal of Otolaryngology (2018).
- Endoscopic myringoplasty: comparison of double layer cartilage-perichondrium graft and single fascia grafting. Journal of Otolaryngology (2020).
- Estapedotomia totalmente endoscópica: técnica e resultados preliminares. Brazilian Journal of Otorhinolaryngology (2011).
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