Abstract
Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis media (n = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope—VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope. Results: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope. Conclusions: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases.
Highlights
Advances in intraoperative optics and new surgical visualization systems such as the three-dimensional (3D) exoscope system have recently been reported as a viable alternative to surgical microscopes and endoscopes [1]
We evaluated the quality of subjective visibility with the 3D exoscope perceived by an operating surgeon and compared it to the operating microscope at all the stages of both surgical procedures
All 30 procedures were completed with the 3D exoscope without requiring a switch to the operating microscope
Summary
Advances in intraoperative optics and new surgical visualization systems such as the three-dimensional (3D) exoscope system have recently been reported as a viable alternative to surgical microscopes and endoscopes [1]. The 3D exoscope is used in a similar manner to a standard operating microscope without a wide field of view, with dual image sensors for 3D visualization. The 3D exoscope can project stereoscopic 3D images to an external monitor, which allows for all observers in the operating theatre (wearing 3D glasses) to see the same high-quality images visualized by the operating surgeon [2,3,4]. It is especially valuable in university settings to improve the learning experience of surgical residents [5]. The aim of the study was to describe our initial experience with the highdefinition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
