Related Experiment Video
Updated: Jul 4, 2026

Discovering Middle Ear Anatomy by Transcanal Endoscopic Ear Surgery: A Dissection Manual
Published on: January 11, 2018
Proportion of middle ear surgeries feasible via transcanal endoscopic ear surgery: A multicenter study in Japan
Hirooki Matsui1, Kunio Mizutari2, Tsukasa Ito1
1Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
Objective:
To prospectively assess the applicability of transcanal endoscopic ear surgery (TEES) in patients with cholesteatoma, chronic otitis media with tympanic membrane perforation, otosclerosis, or middle ear anomalies across 13 hospitals in Japan.
Methods:
This multicenter prospective cohort study included patients with cholesteatoma, chronic otitis media with tympanic membrane perforation, otosclerosis, or middle ear anomalies who underwent middle ear surgery at 13 tertiary referral centers in Japan between 2017 and 2019 (n = 1832). The European Academy of Otology and Neurotology/Japanese Otological Society classification, International Otologic Outcomes Group classification, residual rates, and hearing results were obtained. The percentage of otologic surgeries performed as TEES was determined.
Results:
TEES was performed in 745 of 996 patients (75%) in the study group, including 331 of 500 cholesteatoma patients (66%), 303 of 373 chronic otitis media patients (81%), 70 of 77 otosclerosis patients (91%), and 41 of 46 middle ear anomalies (89%).
Conclusions:
In this multicenter cohort, more than 70% of common middle ear surgeries across major otologic diseases were managed using TEES, indicating that TEES was frequently adopted in routine clinical practice across participating centers in this multicenter cohort.

