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The application of endoscopes and microscopes to middle ear surgery

Presenting Author: Hiroshi Ogawa

Published online by Cambridge University Press:  03 June 2016

Hiroshi Ogawa ,
Shuji Yokoyama  and
Tomohiko Ymauchi
Hiroshi Ogawa
Affiliation:
Fukushima Medical University Aizu Medical Center
Shuji Yokoyama
Affiliation:
Fukushima Medical University Aizu Medical Center
Tomohiko Ymauchi
Affiliation:
Fukushima Medical University Aizu Medical Center
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Abstract

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Learning Objectives: The ratios of microscope and endoscopic use in middle ear surgery in our hospital were investigated, and the effective application of microscopes and endoscopes in middle ear considered.

Objective: The ratios of microscope and endoscopic use in middle ear surgery in our hospital were investigated, and the effective application of microscopes and endoscopes in middle ear considered.

Materials and methods: Middle ear surgery was performed for 63 cases of chronic otitis media with cholesteatoma and 40 cases of chronic otitis media without cholesteatoma in our hospital over a five year period from October, 2011 to September, 2015. The medical records for the 103 patients were reviewed.

Results: Thirty-seven of the 63 cases of chronic otitis media with cholesteatoma underwent surgery with a microscope alone, 15 cases with a combination of microscope and endoscope, and 11 with endoscope alone. Eighteen of the 40 cases of chronic otitis media without cholesteatoma underwent surgery with a microscope alone, 7 cases with a combination of microscope and endoscope, and 15 with endoscope alone. Surgery was performed with an endoscope alone for localized cholesteatoma in the tympanic cavity and for cases in which the edge of the perforation could not be evaluated under microscopic observation. The cases which were required mastoidectomy or in which the edge of perforation was completely visualized underwent surgery with microscope alone.

Discussion: The endoscope has been used as a tool for improving the visual exposure of hidden structures and deep recesses, obtaining a wider angle of view, and achieving minimally invasive intervention. However, its usage during surgery is limited due to its one-hand operation in comparison with surgery under microscopic observation.

Conclusion: The ratios of microscope and endoscope use during middle ear surgery in our hospital were investigated. Improvement in surgical results can be expected by undertaking interventions with an understanding of the advantages and disadvantages of each instrument.

Ethics Committee Approval: Ethics committee approval was received for this study from the local institutional review board (2015/2556).