High-Definition 3D Exoscope in Pediatric Otorhinolaryngology: A Systematic Literature Review

Michele Gaffuri^{1

2

3}, Antonella Miriam di Lullo^{1

4

5}, Eleonora M C Trecca^{1

6

7}, Gennaro Russo^{8

9}, Giulia Molinari^{1

10

11}, Francesca Yoshie Russo^{1

12}, Andrea Albera^{1

13}, Giuditta Mannelli^{8

14}, Massimo Ralli^{1

12}, Mario Turri-Zanoni^{1

15}

Affiliations

¹ Research Group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery, Italy.
² Department of Otolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
³ Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
⁴ Division of Otolaryngology-Head and Neck Surgery, Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples Federico II, Pansini Street n.5, 80131 Naples, Italy.
⁵ CEINGE-Advanced Biotechnology, Salvatore G. Street n.486, 80131 Naples, Italy.
⁶ Department of Maxillofacial Surgery and Otolaryngology, IRCCS Research Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy.
⁷ Department of Otolaryngology, University Hospital of Foggia, 71100 Foggia, Italy.
⁸ Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery, Italy.
⁹ Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, 80131 Napoli, Italy.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
¹¹ Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, 40138 Bologna, Italy.
¹² Department of Sense Organs, ENT Department, Sapienza University of Rome, 00185 Rome, Italy.
¹³ Department of Surgical Sciences, University of Turin, 10124 Turin, Italy.
¹⁴ Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy.
¹⁵ Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy.

PMID: 37892666
PMCID: PMC10607561
DOI: 10.3390/jcm12206528

Review

High-Definition 3D Exoscope in Pediatric Otorhinolaryngology: A Systematic Literature Review

Michele Gaffuri et al. J Clin Med. 2023.

. 2023 Oct 14;12(20):6528.

doi: 10.3390/jcm12206528.

Authors

Affiliations

¹ Research Group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery, Italy.
² Department of Otolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
³ Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
⁴ Division of Otolaryngology-Head and Neck Surgery, Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples Federico II, Pansini Street n.5, 80131 Naples, Italy.
⁵ CEINGE-Advanced Biotechnology, Salvatore G. Street n.486, 80131 Naples, Italy.
⁶ Department of Maxillofacial Surgery and Otolaryngology, IRCCS Research Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy.
⁷ Department of Otolaryngology, University Hospital of Foggia, 71100 Foggia, Italy.
⁸ Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery, Italy.
⁹ Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, 80131 Napoli, Italy.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
¹¹ Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, 40138 Bologna, Italy.
¹² Department of Sense Organs, ENT Department, Sapienza University of Rome, 00185 Rome, Italy.
¹³ Department of Surgical Sciences, University of Turin, 10124 Turin, Italy.
¹⁴ Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy.
¹⁵ Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy.

PMID: 37892666
PMCID: PMC10607561
DOI: 10.3390/jcm12206528

Abstract

This PRISMA-compliant systematic review aimed to investigate the use of and the most common procedures performed with the novel 3D 4K exoscope in surgical pediatric head and neck settings.

Methods: Search criteria were applied to PubMed, EMBASE and the Cochrane Review databases and included all studies published up to January 2023 reporting 3D 4K exoscope-assisted surgeries in pediatric patients. After the removal of duplicates, selection of abstracts and full-text articles, and quality assessment, we reviewed eligible articles for number of patients treated, age, surgical procedures, and outcomes.

Results: Among 54 potentially relevant records, 5 studies were considered eligible and included in this systematic review, with reported treatment data for 182 patients. The surgical procedures belong to the otologic field (121 cases), head and neck surgery (25 cases) and transoral surgery (36 cases). Exoscopy allowed high quality visualization of anatomical structures during cochlear implantation and during reconstruction in head and neck surgery; moreover, it improved the surgical view of surgeons, spectators and ENT students.

Conclusions: The use of 3D 4K exoscopy has shown promising potential as a valuable tool in pediatric ORL-head and neck surgery; nevertheless, further validation of these encouraging outcomes is necessary through larger-scale studies specifically focused on pediatric patients.

Keywords: 3-D imaging; exoscope; exoscopic surgery; otorhinolaryngology; pediatrics; surgical procedure; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
PRISMA flow-chart summarizing the methods used in the present review.

See this image and copyright information in PMC

References

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1. Tewfik K., Rampinelli V., Burlini D., Buffoli B., Rezzani R., Deganello A., Felisati G., Piazza C. Video-Assisted Cleft Palate Surgery: Preclinical Comparison Between Endoscope- and Exoscope-Based Approaches. Cleft Palate Craniofacial J. 2022:10556656221139340. doi: 10.1177/10556656221139340. - DOI - PubMed
1. Festa B.M., Zuppardo J., Costantino A., Ferreli F., Spriano G., Mercante G., De Virgilio A. High-definition 3D exoscope-assisted tonsillectomy. Am. J. Otolaryngol. 2023;44:103674. doi: 10.1016/j.amjoto.2022.103674. - DOI - PubMed
1. Milanesi U., Pasquariello B., Saibene A.M., Felisati G., Atac M., Corbetta D. Three-dimensional exoscope-assisted laser stapedotomy: A preliminary experience. Eur. Arch. Otorhinolaryngol. 2021;278:4593–4598. doi: 10.1007/s00405-021-06672-1. - DOI - PMC - PubMed
1. Remacha J., Navarro-Díaz M., Larrosa F. Experience with three-dimensional exoscope-assisted surgery of giant mastoid process osteoma. J. Laryngol. Otol. 2022;136:875–877. doi: 10.1017/S0022215121004588. - DOI - PubMed

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High-Definition 3D Exoscope in Pediatric Otorhinolaryngology: A Systematic Literature Review

Affiliations

High-Definition 3D Exoscope in Pediatric Otorhinolaryngology: A Systematic Literature Review

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources