This video illustrates an endoscopic ossiculoplasty using a total ossicular replacement prosthesis (TORP) in a patient with a mixed hearing loss and a large conductive component. The video highlights the middle ear anatomy including a dehiscent and prolapsed facial nerve partially obstructing the oval window. Technical pearls for the ossiculoplasty are also highlighted.
Cameron C. Wick, MD
Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
cameron.wick@wustl.edu
J. Walter Kutz Jr., MD
Department of Otolaryngology – Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
walter.kutz@utsouthwestern.edu
Endoscopic ear surgery is an emerging technique championed for its improved visualization within the middle ear space. Stapes surgery presents a unique endoscopic challenge in that it offers a different type of depth perception compared to the binocular microscopic view. This video highlights the surgical steps for an endoscopic stapedotomy using a CO2 laser and Eclipse nitinol piston. The stapes footplate and stapedotomy are well visualized with the endoscope. Just like in endoscopic sinus surgery, depth perception is achieved through muscle-memory and camera movement.
Author: Cameron C. Wick, MD
Institution: Department of Otolaryngology – Head and Neck, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
Email: cameron.wick@wustl.edu
