Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov;278(11):4217-4223.
doi: 10.1007/s00405-020-06510-w. Epub 2021 Jan 2.

Introducing the High-definition 3D exoscope in ear surgery: preliminary analysis of advantages and limits compared with operative microscope

Giovanni Colombo  1   2 , Fabio Ferreli  1   2 , Matteo Di Bari  3   4 , Giovanni Cugini  1 , Stefano Miceli  1 , Armando De Virgilio  1   2 , Giuseppe Spriano  1   2 , Arturo Poletti  5
Affiliations

Introducing the High-definition 3D exoscope in ear surgery: preliminary analysis of advantages and limits compared with operative microscope

Giovanni Colombo et al. Eur Arch Otorhinolaryngol. 2021 Nov.

Abstract

Purpose: The aim of this study was to evaluate the potential of 3D exoscope (EX) in selected ear procedures assessing if this new technology could be an improvement in the field of ear surgery.

Methods: A case series of consecutive patients surgically treated with a post-auricular approach using EX was retrospectively compared with a similar previous series treated with operating microscope (OM). Patient demographics, indications for surgery, procedure type, complications, operating room setting time (ORst), operative time, adequacy of visualization, image quality, ergonomics aspects, instrument usability, and technique as a teaching tool were investigated. Thirteen patients were included in each group. Surgical procedures in EX group were nine tympanoplasties with mastoidectomy, 1 mastoidectomy for acute complicated mastoiditis, 1 revision miringoplasty, and 2 cochlear implants. Same types of procedures were enrolled in OM group.

Results: No statistically significant difference was found between the two groups concerning ORst and operative time. In EX group, one complication occurred--a middle cranial fossa cerebrospinal fluid leak. Advantages of EX were lightness, maneuverability and compactness, less need of endoscopy during surgery, and teaching potential. Limits were a need of a large surgical corridor and the bright structures rendering in high magnification.

Conclusion: EX resulted safe and efficient in treating diseases of the middle ear in post-auricular approaches. To date, EX advantages are not enough to abandon the OM, and it can be considered as an additional, innovative tool to be added to ear surgical equipment.

Keywords: Cochlear implantation; Exoscope; Microscopy; Otologic surgical procedures; Tympanoplasty.

PubMed Disclaimer

References

    1. Mudry A (2000) The history of the microscope for use in ear surgery. Am J Otol 21(6):877–886 - PubMed
    1. Tarabichi M (1997) Endoscopic management of acquired cholesteatoma. Am J Otol 18(5):544–549 - PubMed
    1. Preyer S (2017) Endoscopic ear surgery—a complement to microscopic ear surgery. HNO 65(Suppl 1):29–34. https://doi.org/10.1007/s00106-016-0268-x - DOI - PubMed
    1. Rossini Z, Cardia A, Milani D, Lasio GB, Fornari M, D’Angelo V (2017) VITOM 3D: preliminary experience in cranial surgery. World Neurosurg 107:663–668. https://doi.org/10.1016/j.wneu.2017.08.083 - DOI - PubMed
    1. Kwan K, Schneider JR, Du V, Falting L, Boockvar JA, Oren J, Levine M, Langer DJ (2019) Lessons learned using a high-definition 3-dimensional exoscope for spinal surgery. Oper Neurosurg (Hagerstown) 16(5):619–625. https://doi.org/10.1093/ons/opy196 - DOI

LinkOut - more resources