Endoscopic Ear Surgery

Increasingly, some otolaryngologists are choosing to use endoscopy to perform ear surgeries that have traditionally been done with microscopes, such as tympanoplasty and cholesteatoma removal. Review “A Closer Look at Endoscopic Ear Surgery,” published in the May 2020 issue of ENTtoday, before you answer the question.

Which of the following are NOT factors to consider when physicians are contemplating integrating endoscopic ear surgery (EES) into their practice?

A) Compared to traditional approaches, which may require hunching over a microscope for long periods of time, EES can improve ergonomics for the physician, potentially reducing musculoskeletal pain.

B) EES is a skill likely to soon prove invaluable for most ENT physicians, much in the way the endoscope is now nearly indispensable for sinus surgery. Thus, it is a skill set that all otolaryngologists will need to master.

C) Physicians can perform EES through the ear canal without having to create an incision behind the ear. Some patients find this less invasive approach appealing, e.g., for an endoscopic tympanoplasty.

D) EES presents some challenges, such as having to perform surgeries one-handed. Mastering it takes some time and effort, though doctors with endoscopic experience should be able to pick it up. Practitioners new to the modality should build their skills by such procedures as ear tube placement before attempting more difficult EES procedures such as cholesteatoma removal.

Question by Ruth Jessen Hickman, MD