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Review
. 2020 Mar;15(1):6-16.
doi: 10.1016/j.joto.2018.10.002. Epub 2018 Nov 7.

Getting started in endoscopic ear surgery

Peter Ryan  1 , Carolina Wuesthoff  2 , Nirmal Patel  1   3   4
Affiliations
Review

Getting started in endoscopic ear surgery

Peter Ryan et al. J Otol. 2020 Mar.

Erratum in

Abstract

Endoscopic ear surgery (EES) is an exciting, rapidly developing and innovative field of otologic surgery. Technically and conceptually, EES is a significant departure from traditional microscopic transcanal approaches to the middle ear and canal that has shown very positive results with respect to patient outcomes. This review serves as a primer for the otologist and otology resident embarking on EES and discusses the theory surrounding the learning process, the optical chain for endoscopic surgery as well as other important underlying principles.

Keywords: Endoscopic; Endoscopic Ear Surgery; Optical Chain.

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Figures

Fig. 1
Fig. 1
Angled scope view of attic cholesteatoma sac exemplifying the wide viewing angle of modern endoscopes.
Fig. 2
Fig. 2
Basic EES instruments: Curette (left) and short and long Thomassin dissectors.
Fig. 3
Fig. 3
Karl Storz GmbH specialised EES instrument tray. © Karl Storz GmbH, 2018.
Fig. 4
Fig. 4
Panetti EES instrument tray. © Spiggle & Theis Medizintechnik GmbH, 2018.
Fig. 5
Fig. 5
Downstream equipment issues causing poor image quality. A demonstration of the effect progressive scope damage on the endoscopic image. (Credit Dr Nicholas Jufas).
Fig. 6
Fig. 6
Microscopic view of left stapedectomy.
Fig. 7
Fig. 7
Endoscopic view of left stapedectomy.
Fig. 8
Fig. 8
Ideal neck, shoulder and upper back position for EES with the centre of the screen at eye height. Consider standing, especially for right-handed surgeons operating on the left ear.
Fig. 9
Fig. 9
Recommended operating theatre configuration for single screen endoscopic case.
Fig. 10
Fig. 10
Recommended operating theatre configuration for dual screen endoscopic case.
Fig. 11
Fig. 11
Ideal initial EES case: limited attic disease, uninfected and in a patient with a wide canal.
Fig. 12
Fig. 12
Ideal initial EES case: congenital cholesteatoma.
See this image and copyright information in PMC

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