Transcanal endoscopic tympanoplasty

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

Very stenotic ear canals

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).

Audiogram, CT scan

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

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

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