Middle ear surgery: why and how to switch from microscope to endoscope

Middle ear surgery: why and how to switch from microscope to endoscope. Rationale: Endoscopic-controlled middle ear surgery is a controversial topic in the ENT field. It was introduced in the past few years as an innovative alternative to microscopic-controlled surgery. It offers better visualization of the middle ear and is associated with lower morbidity, but with the same functional results.

Study design: This retrospective study evaluated our recent experiences with this technique, focusing on 70 cases of endoscopic type I tympanoplasty and 42 other cases of middle ear surgery performed under exclusive endoscopic control. The student’s t-test was used for statistical analysis.

Results: There was a tympanic perforation closure rate of 95.7%, with a statistically significant improvement in hearing thresholds and closure of air-bone gaps. We also describe our initial experience, learning curve, and the lessons learned.

Conclusions: We believe endoscopic-controlled middle ear surgery is an effective technique with good anatomical and functional results, offering excellent visualization. Thus, the endoscope is a valid alternative to the microscope. It is a one-handed technique that must be performed step-by-step; therefore, there is a learning curve of several months. Further studies should evaluate the lower morbidity associated with this technique.