Issue N# 3 - 2017
Anatomy of the external auditory canal. Comparative study of microscope versus endoscope
Authors : Ayache S, Beltran M, Guevara N. (Cannes, Nice)
Ref. : Rev Laryngol Otol Rhinol. 2017;138,3:93-98.
Article published in english
Downloadable PDF document english
Objectives: Over the past several years, ear endoscopy has evolved from an additional procedure to microscopy to an exclusive trans external auditory canal surgical technique. This study reports the results of an anatomical study of the external auditory canal and compares microscope and endoscope in transcanal visualization of the tympanic membrane. Design: Retrospective patient series. Setting: Tertiary and secondary case referral centers. Participants: Consecutive patients ful filling the inclusion criteria of the study. Main outcome measure(s): Comparison between microscope and 0° rigid endoscope in transcanal visualization of the tympanic membrane in the clinic setting. Total and partial visualizations of the tympanic membrane and study of anatomical features of the bony external auditory canal are described. Results: Of 5000 patients (10,000 ears), rigid endoscope provided total visualization of the tympanic membrane in 83% versus 10% of ears with microscopic approach. Various anatomical narrowing of the bony external auditory canal are described as well as their effects on visualization of the tympanic membrane through the transcanal endoscopic and microscopic approaches. Conclusions: With a «tunnel» view, the microscope can be limited for a total visualization of the tympanic membrane through the external auditory canal. The tip of the endoscope can help the surgeon to overcome some narrowing of the ear canal, providing a «conical» view of the tympanic membrane. Examination under the microscope may give partial vision of the tympanic membrane. This exposure is certainly better under general anesthesia where you can force without risk of pain for the patient. In contrast, the endoscope offering a conical vision allows in a lot more cases to see the eardrum in its entirety. This is interesting to consider a trans canal surgery whether under a microscope or endoscope.
Price : 14.00 €