Endoscopic Ear Surgery – Incus Interposition for Traumatic Ossicular Discontinuity

Transcanal Endoscopic Middle Ear Exploration with Ossiculoplasty using Incus Interposition Graft

Conductive hearing loss

Active otitis, recent temporal bone trauma

Middle ear endoscopes

All equipment for the endoscopic approach should be in position and in the OR suite prior to the case. This should include endoscopic video tower, to be placed directly opposite the surgeon, rigid endoscopes, and endoscopic middle ear instrumentation. See the following reference for a detailed description of EES OR setup: Cohen et al. Laryngoscope. 2016 Mar;126(3):732-8. doi: 10.1002/lary.25410

Otologic examination, behavioral audiometry, computed tomography of the temporal bones

Rigid endoscopes offer a broader view of the middle ear anatomy, allowing for more landmarks to be present in the visible surgical field at any given time. Critical landmarks in this case include chorda tympani nerve, malleus, incus and stapes, stapedius tendon and pyramidal eminence, cochleariform process, oval window, facial nerve, and round window niche

Bleeding, infection, tympanic membrane perforation, chorda tympani nerve injury, facial weakness, failure to improve hearing, permanent sensorineural hearing loss, perilymph fistula, ear canal stenosis.

N/A

Cohen, M. S., Landegger, L. D., Kozin, E. D. and Lee, D. J. (2016), Pediatric endoscopic ear surgery in clinical practice: Lessons learned and early outcomes. The Laryngoscope, 126: 732â738. doi: 10.1002/lary.25410