Ear disease has plagued mankind since time immemorial. Formal description of opening mastoid was given by Jean Louis Petit (1674-1750), a French surgeon whose findings were published posthumously in 1774. Since then ear surgery has been performed with naked eyes and then with loopes. Although the first description of microscopes dates back to 17th century, it was not until 1921 when Carl Olof Nylen, a Swedish otologist used microscope in ear surgery. The monocular microscope was soon replaced by binocular microscope in 1922 by Gunner Holmgren. The rapid progress of microscopic ear surgery progressed when Littmann and Zeiss Co. introduced their version of microscope which has been perfected over the years [1]. In 1966, Harrold Hopkins developed the Hopkins rod endoscope allowing precise otoendoscopic examination. Marquet in 1975 visualized middle ear hidden areas through a tympanic membrane perforation with help of a 1.7 mm diameter endoscope. Wullstein in 1984 popularized the use of angled endoscopes. In 1997 Tarabichi [2] published a series 36 cases of transcanal endoscopic management of cholesteatoma. Endoscopes come in a wide array of lengths, diameters and angles of views. Each has its own advantages and disadvantages, but general rule is that the larger the diameter of the endoscope, the better the field of view and the better is the illumination. Initially endoscopic ear surgery was performed with 4mm diameter endoscope but now 3 mm diameter endoscope is gaining popularity as it provides near equal view of 4 mm with more instrumentation space. Endoscopic ear surgery (EES) started as a single handed technique and now it’s two handed counterpart [3] is also gaining popularity across the world.

  During the present decade, more otologists are exploring the potential benefits of endoscopic techniques in middle ear cavity and Cerebellopontine (CP) angle. Kapadia and Tarabishi in their study reported that number of publications showing pattern of utilization of endoscope in ear surgery raised many fold from 2011 -2018. In this study it came to light that only 14.30 % surveyed surgeons had not attended any course in endoscopic ear surgery in 2018 whereas the same number was 80.90% in 2010 [4].

References

1. Mudry A. “The history of microscope for use in ear surgery”. American Journal of Otolaryngology 21.6 (2000): 877-886.
2. Tarabichi M. “Endoscopic management of acquired cholesteatoma”. American Journal of Otolaryngology 18.5 (1997): 544-549.
3. Khan MM and Parab S. “Novel method of attaching endoscope holder to microscope for two handed endoscopic tympanoplasty”. Indian Journal of Otolaryngology and Head and Neck Surgery 68.2 (2016): 230-240.
4. Kapadiya M and Tarabichi M. “An overview of endoscopic ear surgery in 2018”. Laryngoscope 6.2 (2019): 365-373.

Citation

Citation: Amit Kumar Rana. “Microscopic to Endoscopic Ear Surgery (EES): Its History and is it the Right Step Towards the Future?". Acta Scientific Otolaryngology 2.3 (2020): 01-02.

Copyright

Copyright: © 2020 Amit Kumar Rana. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.