Incorporating the endoscope into middle ear surgery.

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pediatric Surgery

Background:

• Chronic suppurative otitis media (CSOM) management often requires surgical intervention.
• Accurate visualization of middle ear structures and ossicular chain integrity is crucial for successful tympanoplasty.
• Traditional visualization methods like scutum lowering can be time-consuming.

Purpose of the Study:

• To evaluate the efficacy of a pediatric rigid otoendoscope in assessing middle ear disease extent and ossicular status during tympanoplasty.
• To compare surgical duration and visualization success rates between otoendoscopy and scutum lowering.

Main Methods:

• A prospective study involving 132 patients with CSOM undergoing tympanoplasty.
• 41 patients underwent otoendoscopy, while 91 had scutum lowering for visualization.
• A 30-degree rigid otoendoscope was used to assess middle ear structures and ossicular mobility.

Main Results:

• The otoendoscope allowed successful visualization and mobility assessment in 34 of 41 patients.
• Otoendoscopy group surgery duration averaged 62.85 minutes, significantly shorter than the 71.23 minutes for scutum lowering (p < 0.005).
• Procedures were completed in under 60 minutes in 76.5% of the otoendoscopy group versus 24.5% of the scutum-lowering group (p < 0.005).

Conclusions:

• Incorporating an angled pediatric rigid otoendoscope is a valuable alternative to scutum lowering in middle ear surgery.
• Otoendoscopy improves visualization and significantly reduces operative time.
• This technique offers a more efficient approach to managing chronic suppurative otitis media.