Experts in ear surgery debated the merits of the endoscope in a panel session at the Triological Society Combined Sections Meeting, a discussion that centered largely on the two-handed maneuverability available when using a microscope versus the improved visualization gained when using an endoscope, which leaves just one free hand for the procedure.
Explore this issue:March 2017
Abraham Jacob, MD, associate professor and vice chair of otolaryngology and director of the University of Arizona Ear Institute in Tuscon, Ariz., said the endoscope has led to a more intimate and detailed look at the structures of the middle ear space, such as the retrotympanum and its associated structures, like the proximal portion of the intratemporal facial nerve. This new understanding paves the way for more precise and effective surgery, he said.
Because using an endoscope allows surgeons to sit in a more upright position, as opposed to the more head-forward position required for using a microscope, there may be less strain on the neck, he added. “A lot of people worry about the learning curve, but it’s not too bad,” Dr. Jacob said. “Even my very first case, where I thought I would just be raising a [tympanomeatal] flap, I ended up doing the whole tympanoplasty with the endoscope.”