Endoscopic Middle Ear Cleft Surgery (EMES): Our Philosophy, Concept and Application

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Surgical Anatomy

Background:

• Preserving healthy anatomical structures in ear surgery is crucial for functional outcomes.
• Traditional mastoidectomy techniques often involve significant bone drilling, potentially impacting healthy tissues.

Purpose of the Study:

• To evaluate a transcanal endoscopic dual-hand approach for middle ear and mastoid surgeries.
• To assess the efficacy of minimizing bone drilling while preserving ossicles and healthy surrounding tissues.

Main Methods:

• A prospective study over 12 years (2009-2021) involving 157 adult patients.
• Utilized transcanal endoscopic dual-hand technique with minimal posterior atticotomy and proximal aditotomy.
• Employed angled endoscopes (30 and 45 degrees) and specialized instruments for disease removal.

Main Results:

• Achieved a high graft uptake rate of 93.6%.
• Demonstrated successful disease clearance and preservation of ossicles, middle ear mucosa, and mastoid cortex.
• Confirmed aditus patency through visual inspection, reducing the need for extensive bone drilling.

Conclusions:

• The transcanal endoscopic dual-hand approach is effective for ear surgery, offering functional preservation.
• Minimizing bone drilling and preserving anatomical structures lead to better postoperative results and long-term follow-up.
• This technique enhances patient comfort and surgical efficiency compared to single-hand methods.