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      Endoscopic ear surgery

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          Abstract

          Objectives

          This article reviews the advantages and disadvantages of endoscopic ear surgery (EES).

          Method

          Pubmed, Google and the Proquest Central Database at Kırıkkale University were queried using the keywords “endoscopic ear surgery”, “ear surgery” and “endoscopy” to identify the literature needed for the review.

          Results

          Endoscopes allow for enhanced surgical visualisation. The distal part of the apparatus is illuminated and contains lenses angled to allow a wider view of the operative area. Transcanal endoscopic techniques have transformed the external ear canal (EAC) into an operative gateway. The benefits EES can offer include wider views, enhanced imaging capabilities and increased magnification, and ways to see otherwise poorly visualisable portions of the middle ear. EES permits surgeons to operate using minimally invasive otological techniques. When compared with microscope-assisted surgery, endoscopic tympanoplasty has been shown to require a shorter operating time in some instances. There are a number of drawbacks to EES, however, which include the fact that it is a single-handed technique, that the light source may produce thermal injury and that visualisation using the endoscope is severely curtailed if bleeding is profuse.

          Conclusion

          EES is a safe and effective technique. The current literature supports the idea that the results achieved by endoscopic methods are usually comparably beneficial to results obtained using conventional microscopic methods.

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          Most cited references35

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          Endoscopic-guided otosurgery in the prevention of residual cholesteatomas.

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            Systematic review of outcomes following observational and operative endoscopic middle ear surgery.

            Middle ear surgery increasingly employs endoscopes as an adjunct to or replacement for the operative microscope. We provide a systematic review of endoscope applications in middle ear surgery with an emphasis on outcomes, including the need for conversion to microscope, audiometric findings, length of follow-up, as well as disease-specific outcomes.
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              Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty

              Objectives This study aimed to compare the outcome of endoscopic and microscopic tympanoplasty. Methods This was a retrospective comparative study of 73 patients (35 males and 38 females) who underwent type I tympanoplasty at Samsung Medical Center from April to December 2014. The subjects were classified into two groups; endoscopic tympanoplasty (ET, n=25), microscopic tympanoplasty (MT, n=48). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale (NRS-11), and graft success rate were evaluated. Results The perforation size of the tympanic membrane in ET and MT group was 25.3%±11.7% and 20.1%±11.9%, respectively (P=0.074). Mean operation time of MT (88.9±28.5 minutes) was longer than that of the ET (68.2±22.1 minutes) with a statistical significance (P=0.002). External auditory canal (EAC) width was shorter in the ET group than in the MT group (P=0.011). However, EAC widening was not necessary in the ET group and was performed in 33.3% of patients in the MT group. Graft success rate in the ET and MT group were 100% and 95.8%, respectively; the values were not significantly different (P=0.304). Pre- and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Immediate postoperative pain was similar between the groups. However, pain of 1 day after surgery was significantly less in the ET group. Conclusion With endoscopic system, minimal invasive tympanoplasty can be possible with similar graft success rate and less pain.
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                Author and article information

                Contributors
                Journal
                J Otol
                J Otol
                Journal of Otology
                Chinese PLA General Hospital
                1672-2930
                2524-1753
                02 December 2019
                March 2020
                02 December 2019
                : 15
                : 1
                : 27-32
                Affiliations
                [a ]Doctor Faculty Member in Acıbadem University, Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
                [b ]Eskisehir Osmangazi University, Faculty of Medicine, Department of Otorhinolaryngology, Eskisehir, Turkey
                [c ]Kirikkale University, Faculty of Medicine, Department of Otorhinolaryngology, Kirikkale, Turkey
                [d ]UECE Universidade Estedualda Ceara, Sinus and Oto Centro, Fortaleza, Brazil
                Author notes
                []Corresponding author. Birlik Mahallesi, Zirvekent 2. Etap Sitesi, C-3 blok, No: 6-3/43, 06610, Çankaya, Ankara, Turkey. nuray.bayar@ 123456yahoo.com
                Article
                S1672-2930(19)30136-9
                10.1016/j.joto.2019.11.004
                7033590
                32110237
                15e2ed64-850c-41ff-b016-c906895d15bc
                © 2019 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 26 September 2019
                : 25 November 2019
                : 28 November 2019
                Categories
                Review Article

                endoscopic ear surgery,ear surgery,endoscopy,benefit
                endoscopic ear surgery, ear surgery, endoscopy, benefit

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