Endoscopic Tympanoplasty

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
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Author: Justin Golub
Published:
Specialties: Endoscopy, Otolaryngology
Schools: NewYork Presbyterian Columbia University Medical Center
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Basic Info

Transcanal endoscopic tympanoplasty is illustrated with steps explained. This is a "realistic" case with bleeding and middle ear adhesions; tips to overcome these hurdles are discussed.

DOI# http://dx.doi.org/10.17797/atpw43so2e

Editor Recruited by: Ravi N. Samy

Advanced

Procedure

Transcanal endoscopic tympanoplasty

Indications

Tympanic membrane perforation (particularly when microscope can not see full extend via transcanal approach), middle ear adhesions, conductive hearing loss

Contraindications

Very stenotic ear canals

Instrumentation

Setup

The bed is rotated 90 or 180 degrees and the endoscope tower is directly opposite the surgeon. A microscope is in the room, but does not need to be utilized. A 3x14 mm rigid endoscope with HD camera is used (using 0 and 30 degree tips).

Preoperative Workup

Audiogram, CT scan

Anatomy and Landmarks

Advantages/Disadvantages

Endoscope advantages: more light, higher magnification/clarity, wide field of view, visualization around corners with angled tips, better for teaching (assistants see same image as surgeon)
Endoscope disadvantages: 2D (but get pseudo-3D with movement), one-handed dissection

Complications/Risks

Disclosure of Conflicts

Acknowledgements

The author thanks the operating room staff and administration at NewYork-Presbyterian/Columbia University Medical Center for support of the Endoscopic Ear Surgery Program.

References

Golub JS. Building an endoscopic ear surgery program. Curr Opin Otolaryngol Head Neck Surg. 2016. [In Press]

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