He made these suggestions for surgeons just beginning to use the endoscope:
- Start using standard otology instruments and a 14 cm-length, 3mm-width, 0-degree endoscope.
- Perform your first set of endoscopic procedures on light OR days.
- Start by using just your standard otology instruments.
- Start with simple procedures, such as a straightforward tympanoplasty or even pressure equalizer (PE) tube insertions.
- Be sure to use adequate anti-fog so the scope doesn’t cloud up.
- At first, try using the endoscope only for portions of the surgery with which you’re most comfortable.
Anterior Tympanic Membrane Perforation
Michael Hoffer, MD, professor of otolaryngology and neurotology at the University of Miami in Florida, advocated for using the microscope. “It allows you to use a two-handed technique, and it gives you 3-D vision,” he said.
He said that the lateral graft procedure has been shown to produce the best results for anterior tympanic membrane perforations, but a case involving a lot of bleeding can be very difficult using an endoscope. “I don’t see in this particular case where you would be better off using the endoscope,” he said.