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Preliminary outcomes of endoscopic middle ear surgery, our UK experience

Presenting Author: Constantina Yiannakis

Published online by Cambridge University Press:  03 June 2016

Constantina Yiannakis ,
Rhona Sproat  and
Arunachalam Iyer
Constantina Yiannakis
Affiliation:
NHS Lanarkshire
Rhona Sproat
Affiliation:
NHS Lanarkshire
Arunachalam Iyer
Affiliation:
NHS Lanarkshire
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Abstract

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Learning Objectives:

  • • Review the indications for endoscopic middle ear surgery.

  • • Compare the short-term outcomes of endoscopic with conventional middle ear surgery.

  • • Discuss the application of endoscopic techniques within the UK patient population.

Introduction: Totally Endoscopic Ear Surgery (TEES) and Endoscopic Assisted Microsurgery (EAMS) is still a new concept. Endoscopic techniques for the treatment of pathological conditions of the middle ear have been gradually introduced since 1990. However, relatively few centres in the UK are performing them. Advantages over standard techniques include better visualisation of difficult to reach areas, such as the sinus tympani, and limited external incisions(1, 2).

Here we report our short-term outcomes for endoscopic middle ear surgery.

Methods: We performed a prospective review of the first 97 consecutive patients undergoing TEES or EAMS in Monklands District General Hospital undertaken by one operator. Outcomes assessed were: tympanic membrane healing, audiological data and complications.

Results: 23 patients underwent EAMS while 74 had TEES. Operations performed included: cholesteatoma surgery, stapedectomy and myringoplasty. We had no reported cases of dead ear or permanent facial nerve palsy. Average air-bone gap following stapedectomy was 6.49 dB. The tympanic membrane healing rate was 87%.

Conclusion: Our results confirm that endoscopic middle ear surgery is safe with short-term outcomes that are comparable with conventional surgery. We feel that it offers and exciting way of improving the management of middle ear pathology through improved access and visualisation. This in turn has implications for teaching and training.

References

1. Tarabichi, M, Ayache, S, Nogueira, JF, Al Qahtani, M, Pothier, DD. (2013) Endoscopic management of chronic otitis media and tympanoplasty. Otolaryngol Clin North Am. 46(2):155–63.CrossRefGoogle ScholarPubMed
2. Tarabichi, M. (2010) Transcanal endoscopic management of cholesteatoma, Otol Neurotol. 31(4):580–8.CrossRefGoogle ScholarPubMed