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Systematic Review of Otologic and Neurotologic Surgery Using the 3-dimensional Exoscope.

Harry Chiang¹, Leila Ledbetter², David M Kaylie¹

¹Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina.

Otology & Neurotology Open

|March 22, 2024

Summary

The 3D exoscope shows promise in otologic and neurotologic surgery, appearing comparable to traditional microscopes in safety and efficiency. Further research may confirm its benefits for surgeon comfort and ease of use.

Keywords:

Ergonomics Exoscope Neurotology Otology Skull Base Surgery Technology

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Area of Science:

Otolaryngology
Neurosurgery
Surgical Technology

Background:

The 3-dimensional (3D) exoscope is gaining traction in neurosurgery and is increasingly adopted for otologic and neurotologic procedures.
A lack of consensus exists regarding the safety, efficiency, and utility of the 3D exoscope compared to the traditional operating microscope in these surgical fields.

Purpose of the Study:

To systematically review and evaluate the application of the 3-dimensional (3D) exoscope in otologic and neurotologic surgery.
To compare the exoscope's performance against the traditional microscope.

Main Methods:

A systematic search was performed across MEDLINE/PubMed, Web of Science, Scopus, and EMBASE for studies on 3D exoscope use in otologic/neurotologic surgery.
English language articles were included, focusing on full articles detailing surgical procedures, complications, operative times, and visualization/ergonomic ratings.

Main Results:

Six articles comprising 128 cases (103 exoscopic, 25 microscopic) were analyzed.
Exoscopic procedures included chronic ear disease (21%), cochlear implants (5%), and lateral skull base surgeries (74%).

Conclusions:

Preliminary findings suggest the 3D exoscope is comparable to the operating microscope in safety, visualization, and efficiency.
The exoscope may offer enhanced surgeon comfort and usability in otologic and neurotologic procedures.