Endoscopic middle ear surgery: First steps in a third level hospital

Authors

  • Fabian Alzate Amaya Complejo Hospitalario Universitario A Coruña
  • Liliana Invencio Da Costa Complejo Hospitalario Universitario A Coruña
  • Anselmo Padin Seara Complejo Hospitalario Universitario A Coruña
  • Jose Eugenio Estrada Gromaz Complejo Hospitalario Universitario A Coruña

DOI:

https://doi.org/10.34631/sporl.762

Keywords:

Otologic Surgical Procedures, Endoscopy, Audiometry, Learning Curve, Myringoplasty, Tympanoplasty

Abstract

Introduction: The use of endoscopic ear surgery (EES) is a worldwide tendency. It gives a wider vision, better magnification and depthness of the surgical field. However, there’re still some doubts related to its results in our daily surgical settings. The purpose of this study is to describe patients diagnosed in our center with otologic surgical pathology who were treated through an endoscopicc approach.

Methods:Retrospective cohort study of patients undergoing endoscopic ear surgery during the period from January 2015 to March 2018. Information related to epidemiological features, type of intervention, surgical operation room time, and type of reconstruction, complications, and comparing audiometry results before and after intervention was documented.

Results:48 patients were operated, in which a total of 23 myringoplasties (48%), 16 tympanoplasties (33%) and 9 stapedectomies (19%) were performed. An optimal surgical closure of the perforation was achieved in 17/23 myringoplasties (74%), with a mean operation time (OT) of 88 minutes and from a pre PTA 27.5 dB to a follow up of 19.5 dB. In tympanoplasties , pre PTA went from 45.7 dB to a 30.6dB and OT of 106 minutes. Stapedectomies showed an improvement from 46.6 dB to 20 dB with an OT of 81 minutes. No major postoperative complications were observed.

Conclusions: EES is a reproducible and reliable technique showing new benefits compared to conventional otologic approaches and similar complications. EES has a short learning curve allowing it to be used as an additional element in training programs during the otolaryngology residency, and in our daily basis surgical routine.

Author Biography

Fabian Alzate Amaya, Complejo Hospitalario Universitario A Coruña

Senior resident, Head and neck otolaryngology department Complejo Hospitalario Universitario A Coruña

References

Tarabichi, M Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg. 2010 Jan;62(1):6-24. doi: 10.1007/s12070-010-0007-7.

Kakehata S, Futai K, Sasaki A, et al. Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss: Early results. Otol Neurotol. 2006 Jan;27(1):14-9. doi: 10.1097/01.mao.0000181181.47495.a0.

Poe DS, Rebeiz EE, Pankratov MM, Shapshay SM. Transtympanic endoscopy of the middle ear. Laryngoscope. 1992 Sep;102(9):993-6 doi: 10.1288/00005537-199209000-00007.

Bottrill ID, Poe DS. Endoscope-assisted ear surgery. Am J Otol. 1995 Mar;16(2):158-63.

Ayache S. Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol. 2013 Mar;270(3):853-60. doi: 10.1007/s00405-012-2056-x.

Tarabichi M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg. 2010 Jan;62(1):6-24. doi: 10.1007/s12070-010-0007-7.

Marchioni D, Molteni G, Presutti L. Endoscopic anatomy of the middle ear. Indian J Otolaryngol Head Neck Surg. 2011 Apr;63(2):101-13. doi: 10.1007/s12070-011-0159-0

Usami S, Iijima N, Fujita S, Takumi Y. Endoscopic-assisted myringoplasty. ORL J Otorhinolaryngol Relat Spec. 2001 Sep-Oct;63(5):287-90. doi: 10.1159/000055759.

Migirov L, Wolf M. Transcanal microscope-assisted endoscopic myringoplasty in children BMC Pediatr. 2015 Apr 1;15:32. doi: 10.1186/s12887-015-0351-6.

R. Dundar, et al. Endoscopic versus microscopic approach to type 1 tympanoplasty in children. Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1084-9. doi: 10.1016/j.ijporl.2014.04.013.

Tarabichi M, NogueiraJ F, Marchioni D, Presutti L, Pothier DD, Ayache S. Transcanal endoscopic management of cholesteatoma. Otolaryngol Clin North Am. 2013 Apr;46(2):107-30. doi: 10.1016/j.otc.2012.10.001.

Sarcu D, Isaacson G. Long-term results of endoscopically assisted pediatric cholesteatoma surgery. Otolaryngol Head Neck Surg. 2016 Mar;154(3):535-9. doi: 10.1177/0194599815622441.

Cohen MS, Landegger LD, Kozin ED, Lee DJ. Pediatric Endoscopic Ear Surgery in Clinical Practice: Lessons Learned and Early Outcomes. Laryngoscope. 2016 Mar;126(3):732-8. doi: 10.1002/lary.25410.

Zarcia LB, Moussalem GF, de Andrade JSC, Mangussi-Gomes J, Cruz OLM, Penido NO, et al. Transcanal endoscopic myringoplasty: a case series in a university center. Braz J Otorhinolaryngol. 2016 May-Jun;82(3):321-5. doi: 10.1016/j.bjorl.2015.05.012.

Tarabichi M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg. 2010 Jan;62(1):6-24. doi: 10.1007/s12070-010-0007-7.

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Published

2020-03-10

How to Cite

Alzate Amaya, F., Invencio Da Costa, L. ., Padin Seara, A., & Estrada Gromaz, J. E. (2020). Endoscopic middle ear surgery: First steps in a third level hospital. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 57(2), 57–61. https://doi.org/10.34631/sporl.762

Issue

Section

Review