Abstract
This study was conducted to investigate the efficacy of a self-expandable retainer (SER) for endoscopic visualization of the external auditory canal (EAC). Tympanomeatal flap (TMF) elevation was performed in six cadaveric heads. Two different types of SER were placed. The procedural feasibility was assessed by endoscopic images. Technical success rate, procedure time, endoscopy lens cleaning, and presence of mucosal injuries were analyzed. TMF elevation and SER placement were successful in all specimens and there were no procedure-related complications. The mean procedure time with the SERs was significantly shorter than without (p < 0.001). The mean number of times the endoscopy lens was cleaned during the procedure was significantly lower in the SER group (p < 0.001). In the SER group, endoscopy insertion into the EAC was easier without tissue contact with the lens during the TMF elevation compared with the non-SER group. There were no mucosal injuries. SER placement is effective for endoscopic visualization via the expanded and straightened EAC. A fully covered type of SER is preferable. The device can be useful for endoscopic ear surgery, reducing procedure time and reducing the need for endoscopy lens cleaning during the procedure.
Highlights
The past three decades have witnessed a growth in the use of endoscopy and it is used in several surgical disciplines including otologic surgery [1]
Tympanomeatal flap (TMF) elevation was technically successful in all specimens of the adult human cadaveric heads and there were no procedure-related complications
The mean (±standard deviation (SD)) procedure time for TMF elevation with self-expandable retainer (SER) was significantly shorter than that for TMF elevation without SERs (175.6 ± 10.3 s vs. 312.2 ± 23.4 s; p < 0.001)
Summary
The past three decades have witnessed a growth in the use of endoscopy and it is used in several surgical disciplines including otologic surgery [1]. Endoscopic ear surgery (EES) has several advantages over conventional surgical microscopy. There is a wider field of view, improved resolution with high magnification, and the ability to “see around corners,” allowing direct visualization of normally hidden recesses [2]. The external auditory canal (EAC) is typically used as the approach for surgery, obviating the need to create access pathways or retract soft tissues [3,4,5]. The EAC is about 2.5 cm in length and comprises a lateral cartilaginous portion and a medial bony portion [6,7]. There is a natural curvature to the external meatus which plays little role in endoscopy
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