Related Experiment Video
Updated: Jul 18, 2025
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
Minimally invasive ossiculoplasty via an endoscopic transtympanic approach
A Saadoun1, C Guigou2, A Lavedrine1
1Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France.
Introduction:
The aim of this study was to evaluate the feasibility of ossiculoplasty via a minimally invasive endoscopic transtympanic approach (ETTA).
Case Series:
We investigated the exposure of target structures (incus and stapes) on 4 human temporal bones by placing an endoscope into the middle ear cleft through the 4 tympanic quadrants. Then, on 3 additional specimens, we performed an incudostapedial disjunction and repaired it with a drop of hydroxyapatite cement via ETTA. We measured the size of tympanic perforation, and the acoustic transfer function of the middle ear (125-8000Hz) before and after repair by placing an insert in the external auditory canal and recording the acoustic signal in the utricle by a microphone. The acoustic signal gain was estimated in dB μV. Exposure was similar in all four quadrants but ergonomics was better with a posteroinferior myringotomy. Ossicular chain repair was conducted successfully in all cases and the acoustic transfer function of the middle ear was significantly improved. Residual tympanic perforation (n=3) was 2±0.3mm in diameter.
Conclusion:
ETTA to reconstruct incudostapedial joint with bone cement was feasible and effective. It opens perspectives for robot-based procedures guided by augmented reality.
