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Related Experiment Video

Updated: Jan 19, 2026

Discovering Middle Ear Anatomy by Transcanal Endoscopic Ear Surgery: A Dissection Manual
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Published on: January 11, 2018

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Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques.

Lukas Anschuetz1, Daniel Stricker2, Abraam Yacoub3

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. anschuetz.lukas@gmail.com.

BMC Medical Education
|September 16, 2019
PubMed
Summary

Endoscopic ear surgery training reduces damage to surrounding tissues compared to microscopic techniques. Medical students trained first with endoscopy performed significantly faster, indicating its benefit for basic surgical skills.

Keywords:
EducationEndoscopeEndoscopic ear surgeryMicroscopeSurgical skillsTeaching

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Area of Science:

  • Otolaryngology
  • Surgical Education
  • Medical Simulation

Background:

  • Endoscopic ear surgery is increasingly popular for teaching middle ear anatomy and surgical skills.
  • The endoscopic approach offers wide-angled views, differing significantly from traditional microscopic techniques.
  • This study compares skill acquisition using endoscopic versus microscopic techniques under standardized conditions.

Purpose of the Study:

  • To compare the effectiveness of endoscopic and microscopic techniques in teaching basic ear surgery skills.
  • To evaluate surgical times, error rates (damages to surrounding structures), and learning curves across different surgeon training levels.
  • To assess surgeon preference between the two techniques.

Main Methods:

  • A randomized study involving final-year medical students, residents, and consultants.
  • Participants performed standardized grasping and dissecting tasks in a temporal bone model using both endoscopic and microscopic techniques (crossover design).
  • Surgical times, number of attempts, and accidental damages were recorded.

Main Results:

  • Surgical task completion times were similar for both techniques but highly dependent on training level.
  • Microscopic techniques resulted in significantly more damages to the ossicular chain compared to endoscopic techniques (p < 0.001).
  • Medical students starting with the endoscopic technique completed tasks significantly faster (p = 0.04) and showed a preference for it.

Conclusions:

  • The endoscopic approach is beneficial for teaching basic surgical skills, reducing tissue damage while maintaining similar operating times.
  • Endoscopic training can improve surgical skill acquisition, particularly for novice surgeons.
  • Medical students benefit from initial training in endoscopic ear surgery, showing faster task completion and preference.