Combined endoscopic and microscopic approaches to cholesteatoma

Publication date: Available online 12 January 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Joao Flavio Nogueira
Use of rigid endoscopes for visualization in the middle ear have allowed for many procedures which were previously limited to postauricular approaches to be performed in transcanal fashion. Additional benefits of the endoscope include superior visualization, angled perspectives to allow for disease removal without direct line of sight, and wider field of view to allow simultaneous visualization of multiple structures.While maximum benefit from the endoscope may occur with transcanal endoscopic ear surgery, there remains a critical role for the endoscope in combined-approach surgery. Not only can middle ear disease be removed with the endoscope in such cases, but the properties of endoscopic visualization allow for detection of occult mastoid disease. The unique perspective of the middle ear seen through the mastoid along with the ability to insert an instrument through the mastoid while looking through the ear canal (and vice versa) can help achieve surgical goals.



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