Ignacio J Fernandez1,2, Marco Bonali3, Michael Ghirelli4, Livio Presutti3. 1. Otolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy. ignaciojavier.fernandez@unimore.it. 2. University Hospital of Modena (Policlinico di Modena, Azienda Ospedaliero-Universitaria di Modena, Università di Modena e Reggio Emilia), Via del Pozzo 71, 41124, Modena, Italy. ignaciojavier.fernandez@unimore.it. 3. Otolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy. 4. Otolaryngology Head and Neck Surgery Department, Ospedale Infermi di Rimini, Rimini, Italy.
Abstract
BACKGROUND: In recent decades, endoscopic ear surgery (EES) has been rapidly evolving, expanding its boundaries from the middle ear to the lateral skull base. Nonetheless, the advantages of the endoscopic technique are associated with a number of intrinsic limitations. METHODS AND OBJECTIVE: A narrative review was conducted to investigate the current limits of EES, analyzing the different otologic and skull base surgery procedures. RESULTS: Limitations of EES can be divided into general and procedure-related. General limitations have been extensively described in the literature and are related to the bidimensional image provided by the endoscope, as well as the one-handed surgical technique and its implications in the management of bleeding. Procedure-related limits are continuously evolving and are also discussed in the present review. CONCLUSION: Although endoscope use is intrinsically associated with general limitations, these have been systematically overcome by the refinement of the surgical technique as a consequence of the increasing surgical experience gained over the last 20 years. The main limits of EES are currently associated with specific procedure- and disease-related situations. This review describes the general limitations and their management, as well as the current limits in the endoscopic management of various otologic diseases, from the external ear to the lateral skull base.
BACKGROUND: In recent decades, endoscopic ear surgery (EES) has been rapidly evolving, expanding its boundaries from the middle ear to the lateral skull base. Nonetheless, the advantages of the endoscopic technique are associated with a number of intrinsic limitations. METHODS AND OBJECTIVE: A narrative review was conducted to investigate the current limits of EES, analyzing the different otologic and skull base surgery procedures. RESULTS: Limitations of EES can be divided into general and procedure-related. General limitations have been extensively described in the literature and are related to the bidimensional image provided by the endoscope, as well as the one-handed surgical technique and its implications in the management of bleeding. Procedure-related limits are continuously evolving and are also discussed in the present review. CONCLUSION: Although endoscope use is intrinsically associated with general limitations, these have been systematically overcome by the refinement of the surgical technique as a consequence of the increasing surgical experience gained over the last 20 years. The main limits of EES are currently associated with specific procedure- and disease-related situations. This review describes the general limitations and their management, as well as the current limits in the endoscopic management of various otologic diseases, from the external ear to the lateral skull base.
Authors: Mohamed Badr-El-Dine; Adrian L James; Giuseppe Panetti; Daniele Marchioni; Livio Presutti; João Flávio Nogueira Journal: Otolaryngol Clin North Am Date: 2013-04 Impact factor: 3.346