Our Summary

This research paper is a review of studies on total endoscopic ear surgery, a type of ear surgery that uses an endoscope (a tube with a light and camera attached to it) to see inside the ear. This method is becoming more popular because it gives doctors a better view of the middle ear and any issues it might have, compared to traditional methods using a microscope.

The paper highlights that there are only a few studies on endoscopic tympanoplasty (surgery to repair a hole in the eardrum) and stapes surgeries (surgery to fix a tiny bone in the ear that helps with hearing). The results from these studies show that endoscopic ear surgery can successfully close the hole in the eardrum in 84.0% to 97.2% of cases, and improve hearing levels. The rates of successful hearing improvement in stapes surgeries range from 56.0% to 86.7%. The paper also notes that the complication rates for these surgeries are similar to those done using a microscope.

In conclusion, endoscopic ear surgeries seem to be well-tolerated by patients and have similar risks to traditional microscopic procedures. However, more research is needed to understand patient experiences and long-term results.

FAQs

  1. What is the reported perforation closure rate for total endoscopic ear surgery tympanoplasty?
  2. How do the complication rates for endoscopic tympanoplasty and stapes procedures compare to microscopic procedures?
  3. Are there many studies available on endoscopic tympanoplasty and stapes procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow post-operative instructions carefully, including keeping the ear dry and avoiding activities that could put pressure on the ear, such as heavy lifting or straining. It is also important to attend follow-up appointments to monitor healing and address any concerns.

Suitable For

Patients who may be recommended for tympanoplasty include those with chronic ear infections, perforated eardrums, hearing loss, or other middle ear issues that have not responded to conservative treatments. Endoscopic tympanoplasty may be recommended for patients who have failed previous microscopic tympanoplasty or for those who may benefit from the improved visualization offered by the endoscope. Additionally, patients with otosclerosis or other conductive hearing loss issues may be recommended for endoscopic stapes surgery.

Timeline

Before tympanoplasty:

  1. Patient presents with symptoms such as hearing loss, ear pain, ear discharge, and/or recurrent ear infections.
  2. Patient undergoes a thorough medical history and physical examination by an ENT specialist.
  3. Audiological testing is conducted to assess the extent of hearing loss.
  4. Imaging studies, such as a CT scan or MRI, may be performed to evaluate the middle ear structures.
  5. Surgical consent is obtained from the patient after discussing the risks and benefits of the procedure.

After tympanoplasty:

  1. Patient undergoes tympanoplasty surgery under general anesthesia, which may be performed using a microscope or endoscope.
  2. The tympanic membrane is repaired using a graft taken from the patient’s own tissues or a synthetic material.
  3. Following surgery, the patient may experience mild pain or discomfort, which can be managed with pain medications.
  4. A follow-up appointment is scheduled to monitor the healing process and remove any packing or sutures.
  5. Audiological testing is performed to assess hearing improvement post-surgery.
  6. The patient is advised to avoid activities that may increase pressure in the ear, such as flying or diving, during the recovery period.
  7. Long-term follow-up appointments are scheduled to monitor the success of the surgery and address any potential complications.

What to Ask Your Doctor

  1. What is the success rate for tympanoplasty using the endoscopic approach compared to the traditional microscope approach?
  2. What are the potential complications associated with endoscopic tympanoplasty and stapes surgery?
  3. How long is the recovery period following endoscopic tympanoplasty or stapes surgery?
  4. Are there any specific limitations or contraindications for undergoing endoscopic ear surgery?
  5. What are the expected outcomes in terms of hearing improvement following endoscopic tympanoplasty or stapes surgery?
  6. Will I need to undergo any additional procedures or treatments after the surgery?
  7. How experienced are you in performing endoscopic ear surgeries, and what is your success rate with these procedures?
  8. What are the potential risks or side effects of anesthesia during the surgery?
  9. How long will the results of the surgery last, and are there any long-term considerations to be aware of?
  10. Are there any specific post-operative care instructions or precautions I should follow after the surgery?

Reference

Authors: Hunter JB, O’Connell BP, Rivas A. Journal: Curr Opin Otolaryngol Head Neck Surg. 2016 Oct;24(5):388-94. doi: 10.1097/MOO.0000000000000297. PMID: 27540993