Transcanal endoscopic tympanoplasty is illustrated with steps explained. This is a “realistic” case with bleeding and middle ear adhesions; tips to overcome these hurdles are discussed.
Editor Recruited by: Ravi N. Samy
Transcanal endoscopic tympanoplasty
Tympanic membrane perforation (particularly when microscope can not see full extend via transcanal approach), middle ear adhesions, conductive hearing loss
Very stenotic ear canals
The bed is rotated 90 or 180 degrees and the endoscope tower is directly opposite the surgeon. A microscope is in the room, but does not need to be utilized. A 3x14 mm rigid endoscope with HD camera is used (using 0 and 30 degree tips).
Audiogram, CT scan
Endoscope advantages: more light, higher magnification/clarity, wide field of view, visualization around corners with angled tips, better for teaching (assistants see same image as surgeon)
Endoscope disadvantages: 2D (but get pseudo-3D with movement), one-handed dissection
The author thanks the operating room staff and administration at NewYork-Presbyterian/Columbia University Medical Center for support of the Endoscopic Ear Surgery Program.
Golub JS. Building an endoscopic ear surgery program. Curr Opin Otolaryngol Head Neck Surg. 2016. [In Press]