scholarly journals Feasibility of Endoscopic Treatment of Middle Ear Myoclonus: A Cadaveric Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Natasha Pollak ◽  
Roya Azadarmaki ◽  
Sidrah Ahmad
Keyword(s):  
Middle Ear ◽  
Cadaveric Study ◽  
Endoscopic Approach ◽  
Endoscopic Ear Surgery ◽  
Pulsatile Tinnitus ◽  
First Line ◽  
Invasive Treatment ◽  
Ear Surgery ◽  
Tissue Dissection ◽  
Temporal Bones

Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performed to control pulsatile tinnitus due to middle ear myoclonus and for several other indications. We designed a cadaveric study to assess the feasibility of an entirely endoscopic approach to stapedius and tensor tympani tenotomy. We performed this endoscopic ear surgery in 10 cadaveric temporal bones and summarized our experience. Endoscopic stapedius and tensor tympani section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as the first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize tissue dissection. The entire operation, including raising the tympanomeatal flap and tendon section, can be safely completed under visualization with a rigid endoscope.

scholarly journals A Transcanal Endoscopic Approach for Management of Pulsatile Tinnitus due to High-Riding Dehiscent Jugular Bulb

2021 ◽  
pp. 014556132110436
Author(s):  
David Shang-Yu Hung ◽  
Wei-Ting Lee ◽  
Yi-Lu Li ◽  
Jiunn-Liang Wu
Keyword(s):  
Middle Ear ◽  
Coil Embolization ◽  
Jugular Bulb ◽  
Endoscopic Ear Surgery ◽  
Pulsatile Tinnitus ◽  
Clinical Consideration ◽  
Ear Surgery ◽  
High Jugular Bulb ◽  
Endovascular Coil Embolization ◽  
Transmastoid Approach

Pulsatile tinnitus (PT) caused by a high-riding dehiscence jugular bulb (HDJB) is a rare but treatable otology disease. There are several managements include transcatheter endovascular coil embolization, transvenous stent–assisted coil embolization, or resurfacing the dehiscent bony wall of high jugular bulb under the use of microscope. Among those options, surgical resurfacing of HDJB might be an effective and safe choice with less destruction. However, previous studies approached middle ear cavity via microscope can only provide a lateral, indirect view, while resurfacing the vessel through a transcanal endoscopic ear surgery (TEES) approach may give surgeon a direct and easy way to manage HDJB. In this report, we presented a case of 40-year-old woman with HDJB and shared our clinical consideration and reasoning of the surgical management of PT via a transtympanic approach by TEES rather than a transmastoid approach.

Does tranexamic acid improve intra-operative visualisation in endoscopic ear surgery? A double-blind, randomised, controlled trial

2019 ◽  
Vol 133 (12) ◽  
pp. 1033-1037 ◽  
Author(s):  
A Das ◽  
S Mitra ◽  
D Ghosh ◽  
S Kumar ◽  
A Sengupta
Keyword(s):  
Tranexamic Acid ◽  
Middle Ear ◽  
External Auditory Canal ◽  
Soft Tissues ◽  
Controlled Trial ◽  
Control Group ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Significant Difference ◽  
Surgical Field

AbstractObjectiveTo assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.MethodsFifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.ResultsThe Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.ConclusionTranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.

Optical coherence tomography of the oval window niche

2009 ◽  
Vol 123 (6) ◽  
pp. 603-608 ◽  
Author(s):  
T Just ◽  
E Lankenau ◽  
G Hüttmann ◽  
H W Pau
Keyword(s):  
Optical Coherence Tomography ◽  
Middle Ear ◽  
Imaging Modality ◽  
Oval Window ◽  
Annular Ligament ◽  
Middle Ear Surgery ◽  
Optical Coherence ◽  
Ear Surgery ◽  
Temporal Bones

AbstractObjective:Optical coherence tomography was used to study the stapes footplate, both in cadaveric temporal bones and during middle-ear surgery.Materials and methods:Optical coherence tomography was conducted on five temporal bone preparations (from two children and three adults) and in eight patients during middle-ear surgery. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used for standard middle-ear surgical procedures.Results:This optical coherence tomography investigation enabled in vivo visualisation and documentation of the annular ligament, the different layers of the footplate and the inner-ear structures, both in non-fixed and fixed stapes footplates. In cases of otosclerosis and tympanosclerosis, an inhomogeneous and irregularly thickened footplate was found, in contrast to the appearance of non-fixed footplates. In both fixed and non-fixed footplates, there was a lack of visualisation of the border between the footplate and the otic capsule.Conclusions:Investigation of the relatively new technology of optical coherence tomography indicated that this imaging modality may assist the ear surgeon to assess the oval window niche intra-operatively.

Correlation of Radiologic Versus Endoscopic Visualization of the Middle Ear: Implications for Endoscopic Ear Surgery

2020 ◽  
Vol 41 (9) ◽  
pp. e1122-e1127 ◽  
Author(s):  
Marco Bonali ◽  
Matteo Fermi ◽  
Matteo Alicandri-Ciufelli ◽  
Francesco Mattioli ◽  
Domenico Villari ◽  
...  
Keyword(s):  
Middle Ear ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery

Safety and Efficacy of Chitosan-Dextran Hydrogel in the Middle Ear in an Animal Model

2016 ◽  
Vol 21 (4) ◽  
pp. 254-260
Author(s):  
Selin Ünsaler ◽  
Bora Başaran ◽  
Şule Öztürk Sarı ◽  
Eyüp Kara ◽  
Kemal Değer ◽  
...  
Keyword(s):  
Middle Ear ◽  
Auditory Brainstem ◽  
Contralateral Side ◽  
Auditory Brainstem Responses ◽  
Control Group ◽  
Ear Surgery ◽  
Significant Difference ◽  
Intratympanic Injection ◽  
Temporal Bones ◽  
Histopathologic Findings

Objectives: To investigate the efficacy of chitosan-dextran hydrogel (CDH) in preventing postoperative adhesions between the tympanic membrane (TM) and intratympanic structures, and to evaluate its ototoxicity in an animal study. Methods: In the first step, ototoxicity was evaluated with 7 male albino guinea pigs (GPs) via auditory brainstem responses (ABR) before and 4 weeks after unilateral intratympanic injection of CDH and saline solution contralaterally. In the second step, 12 GPs underwent bilateral ear surgery. The middle ear (ME) mucosa was abraded, and the cavity was filled with CDH on one side and packed with Gelfoam on the contralateral side. A control group of 6 GPs underwent the same procedure except that no material was applied in the ME. The animals were euthanized at the end of the 7th week, and otomicroscopic findings were noted and the temporal bones harvested for the histologic examination. The findings were scored and compared. Results: There was no statistically significant difference between the pre- and postoperative ABR thresholds. In the otomicroscopic findings, the most prominent difference between the two groups was the presence of retraction of the TM in the Gelfoam group. The histopathologic findings revealed a higher degree of inflammation in the Gelfoam group compared with the CDH group. Conclusion: This study demonstrated that CDH has no ototoxic effects in GPs. Its use as an ME packing material revealed significantly less TM retraction and inflammatory reaction compared with Gelfoam.

Endoscopic ear surgery: a hot topic?

2017 ◽  
Vol 131 (2) ◽  
pp. 117-122 ◽  
Author(s):  
S Mitchell ◽  
C Coulson
Keyword(s):  
Middle Ear ◽  
Descriptive Analysis ◽  
Relevant Literature ◽  
Heat Exposure ◽  
Middle Ear Surgery ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Potential Factors ◽  
Negative Impacts ◽  
Published Research

AbstractObjectives:To summarise published research investigating maximal temperatures associated with endoscopes used in otology. Possible thermal issues surrounding the use of endoscopes in middle-ear surgery are discussed, and recommendations regarding the safest ways to use endoscopes in endoscopic ear surgery are made.Methods:A non-systematic review of the relevant literature was conducted, with descriptive analysis and presentation of the results.Results:There are currently no reports of any temperature-related deleterious effects in patients having undergone endoscopic ear surgery. There is debate regarding heat issues in endoscopic ear surgery, with a limited body of work documenting potential negative impacts of middle-ear heat exposure from endoscopes. The diameter of endoscope, type of light source used, distance from endoscope tip and duration of exposure are highlighted potential factors for high temperatures in endoscopic ear surgery.Conclusion:There is a trend towards endoscopes being used routinely in ear surgery. Simple practice points are recommended to minimise potential thermal risks.

Feasibility of ovine and synthetic temporal bone models for simulation training in endoscopic ear surgery

2019 ◽  
Vol 133 (11) ◽  
pp. 966-973 ◽  
Author(s):  
S Okhovat ◽  
T D Milner ◽  
A Iyer
Keyword(s):  
Temporal Bone ◽  
Content Validity ◽  
Interquartile Range ◽  
Face Validity ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Specific Content ◽  
The Face ◽  
Temporal Bones ◽  
Endoscopic Tympanoplasty

AbstractObjectiveComparing the feasibility of ovine and synthetic temporal bones for simulating endoscopic ear surgery against the ‘gold standard’ of human cadaveric tissue.MethodsA total of 10 candidates (5 trainees and 5 experts) performed endoscopic tympanoplasty on 3 models: Pettigrew temporal bones, ovine temporal bones and cadaveric temporal bones. Candidates completed a questionnaire assessing the face validity, global content validity and task-specific content validity of each model.ResultsRegarding ovine temporal bone validity, the median values were 4 (interquartile range = 4–4) for face validity, 4 (interquartile range = 4–4) for global content validity and 4 (interquartile range = 4–4) for task-specific content validity. For the Pettigrew temporal bone, the median values were 3.5 (interquartile range = 2.25–4) for face validity, 3 (interquartile range = 2.75–3) for global content validity and 3 (interquartile range = 2.5–3) for task-specific content validity. The ovine temporal bone was considered significantly superior to the Pettigrew temporal bone for the majority of validity categories assessed.ConclusionTympanoplasty is feasible in both the ovine temporal bone and the Pettigrew temporal bone. However, the ovine model was a significantly more realistic simulation tool.

COMPARISON OF THE EFFICACY OF ENDOSCOPIC TYMPANOPLASTY WITH MICROSCOPIC TYMPANOPLASTY

2021 ◽  
pp. 52-55
Author(s):  
Anjana Tigga ◽  
Shruti Dhingra
Keyword(s):  
Hospital Stay ◽  
Middle Ear ◽  
Past Century ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Camera System ◽  
Health Care Centre ◽  
Minimally Invasive Surgical ◽  
Microscopic Tympanoplasty ◽  
Endoscopic Tympanoplasty

Introduction: Otological surgery has progressed rapidly over the past century. With the recent introduction of the 3-chip camera system and high denition video systems, endoscopes now provide ultra high resolution images of the middle ear that were never seen previously. We conducted this study to compare the efcacy of endoscopictympanoplasty over microscopic tympanoplasty in terms of preoperative ease of surgery including visualisation of ossicles and eustanchian tube and intraoperative bleeding, graft uptake, hearing improvement, post-operative pain score, post-auricular hypoesthesia, duration of hospital stay etc. Methods: The present study is prospective observational study, conducted in a Tertiary Health Care Centre. Results: Endoscopic tympanoplasty has many advantages over microscopic tympanoplasty and can be a better alternative or adjuct to microscopic tympanoplasty. Conclusion: Endoscopic ear surgery provides a better magnication, wide eld view, and the ability to look around corners. Further more transcanal endoscopic ear surgery (TESS) approaches transform external auditory canal into a minimally invasive surgical portal to access middle ear disease. The ease of surgery improves with time and has a gradual learning curve. The graft uptake rate is comparable with both approaches. The overall satisfaction score in terms of reduced pain and hypoesthesia with decreased hospital stay is higher in endoscopic approach.

In Vivo Measurements of Middle Ear Temperature During Transcanal Endoscopic Ear Surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Petra Beláková ◽  
Richard Salzman ◽  
Martin Hyravý ◽  
Jan Heřman
Keyword(s):  
Middle Ear ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
In Vivo Measurements
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