Learning Objectives:

• • Basic principles of endoscopic ear surgery.

• • Surgical results from a starting endoscopic ear surgery practice including cholesteatoma and tympanoplasty.

Introduction: Endoscopic ear surgery offers an unparalleled view of the middle ear thanks to the wide-angle field of view and is increasingly gaining popularity amongst ENT-surgeons worldwide. However, the transition from operating with the microscope to the endoscope is challenging, primarily due to operating one-handed, but also adjusting to the different view achieved with the endoscope.

Methods: This study shows a preliminary retrospective overview of a consecutive series of all endoscopic ear surgery cases performed by one ENT-surgeon since starting his EES practice two years ago.

Results: Hundred and five consecutive patients were included in the study group, including 46 cholesteatoma cases, 52 type 1 tympanoplasties and 7 PORP ossiculoplasties. No major adverse events or incidences were noted. In 3 cases the endoscopic approach had to be converted to a microscopic post auricular approach for complete removal of cholesteatoma. Overall, 9 out of the 105 surgeries (8.6%) resulted in a postoperative residual perforation. In one case recurrence of cholesteatoma was noted 21 months post operatively. Overall average follow-up time was 6.4 months (range 1–20 months).

Conclusions: Results demonstrate that a surgeon can pick up the necessary skills relatively quickly and achieve acceptable success rates while delivering the reduced morbidity associated with EES.