Endoscopic ear surgery

Endoscopic ear surgery, or "EES," is defined as the use of the rigid endoscope, in contrast to the operating room microscope, to visualize the middle and inner ear during otologic surgery.[1] During endoscopic ear surgery the surgeon holds the endoscope in one hand while working in the ear with the other. To allow this kind of single-handed surgery, different surgical instruments have to be used. Endoscopic visualization has improved due to high-definition video imaging and wide-field endoscopy, and being less invasive, EES is gaining importance as an adjunct to microscopic ear surgery.

Endoscopic ear surgery
Specialtyotolaryngology

History

Endoscopic Ear Surgery was first truly pioneered by Muaaz Tarabichi MD in Dubai during the late 90s. His contributions to the field have led to him being recognized globally as the father of endoscopic ear surgery. He now lectures extensively on the topic worldwide.[2] Similar to the early years of FESS (functional endoscopic sinus surgery),[3] EES has been controversial since early descriptions in the 1960s.[4] One of the benefits of an endoscope compared to the microscope is the wide-field view of the middle ear afforded by the location of the light source at the tip of the instrument and the availability of various types of angled lenses. Middle ear procedures that utilize a rigid endoscope for viewing may reduce the need to drill for enhanced exposure of the operative field.[5] The traditional otologic operating microscopes typically require larger portals (e.g., postauricular approaches) to enable adequate passage of light for intraoperative viewing and follow-up surveillance in the clinic.[6] One handed dissection is cited as the main drawback to EES.

The indications for this relatively new technique are evolving. The use of rigid endoscopes to perform ear surgery (operative EES), rather than just to visualize the contents of the middle ear (observational EES), is increasing as optimized instrumentation and operative approaches become available.[7]

Classification System: [8]

Class 0: Microscopic only case

Class 1: Inspection with endoscope

Class 2: Mixed dissection with endoscope and microscope

Class 3: Endoscopic only case

References
  1. "IWGEES - International Working Group on Endoscopic Ear Surgery".
  2. "In conversation with Muaaz Tarabichi". ENT & Audiology News. Retrieved 2021-01-13.
  3. Vining EM, Kennedy DW (July 1994). "The transmigration of endoscopic sinus surgery from Europe to the United States". Ear, Nose, & Throat Journal. 73 (7): 456–8, 460. PMID 8082598.
  4. Mer SB, Derbyshire AJ, Brushenko A, Pontarelli DA (April 1967). "Fiberoptic endotoscopes for examining the middle ear". Archives of Otolaryngology (Chicago, Ill. : 1960). 85 (4): 387–93. doi:10.1001/archotol.1967.00760040389009. PMID 6021747.
  5. Kozin ED, Gulati S, Kaplan AB, Lehmann AE, Remenschneider AK, Landegger LD, et al. (May 2015). "Systematic review of outcomes following observational and operative endoscopic middle ear surgery". The Laryngoscope. 125 (5): 1205–14. doi:10.1002/lary.25048. PMC 4467784. PMID 25418475.
  6. Badr-El-Dine M, James AL, Panetti G, Marchioni D, Presutti L, Nogueira JF (April 2013). "Instrumentation and technologies in endoscopic ear surgery". Otolaryngologic Clinics of North America. 46 (2): 211–25. doi:10.1016/j.otc.2012.10.005. PMID 23566907.
  7. Kapadiya M, Tarabichi M (June 2019). "An overview of endoscopic ear surgery in 2018". Laryngoscope Investigative Otolaryngology. 4 (3): 365–373. doi:10.1002/lio2.276. PMC 6580051. PMID 31236473.
  8. Cohen MS, Landegger LD, Kozin ED, Lee DJ (March 2016). "Pediatric endoscopic ear surgery in clinical practice: Lessons learned and early outcomes". The Laryngoscope. 126 (3): 732–8. doi:10.1002/lary.25410. PMID 26228434.
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