AB089. 2. Otoendoscopy—a new eye on the ear

Background: Traditionally otologic surgeries are carried out under the microscope. Incisions, overnight stays and post op complications need to be considered. Otoendoscopy, [totally trans-canal endoscopic ear surgery (TEES)] is the use of a rigid endoscope to aid visualization during middle ear surgery. TEES is technically challenging, procedures are minimally invasive, endoscopes provide a wide field of view and superior access to complex anatomy. A small but increasing number of otologists are adapting this novel technique worldwide. Our aim is to share our experience of TEES.

Methods: Following ethical approval, a retrospective review of 1,755 ear surgeries from the year 2008 to September 2018 was undertaken. Patient information was compiled from surgical registers and clinical notes. Senior author performed the first TEES in 2013 at University College Hospital, Galway, Ireland (UCHG).

Results: Microscope was used exclusively from 2008 to 2013. Since 2013 an endoscope has been used in 198 otologic surgeries, procedures included ventilation-tube insertion, tympanoplasty, cholesteatoma surgery and ossicular chain reconstruction. All TEES procedures were carried out as day case surgeries. Procedures were photo documented. TEES is limited by ear canal diameter but is suitable for all ages. Recovery is quicker and less complicated, no external incisions are made. Overall the microscope was used in 1,557 procedures. Otoendoscopy has increased each year for the past 6 years, 68 procedures in 2017 compared to 3 in 2013.

Conclusions: The use of endoscopes in ear surgeries is increasing. While challenging, otoendoscopy allows improved surgical exposure, better visualization and tackles ear disease efficiently. Recovery is quicker and less complicated.

Keywords: Audit; ear surgery; novel technique; otoendoscopy