Adrian L James1,2. 1. Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Canada. adr.james@utoronto.ca. 2. Department of Otolaryngology, Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Canada. adr.james@utoronto.ca.
Abstract
BACKGROUND: Transcanal totally endoscopic ear surgery (TEES) has become increasingly popular internationally; however, for surgeons trained with a two-handed microscope-guided approach, the potential challenges of adopting TEES can appear off-putting. OBJECTIVES: This article outlines the pros and cons of TEES for tympanic membrane repair and describes aspects of surgical technique relevant to those who might adopt this approach. MATERIALS AND METHODS: Data are provided from the author's experience along with a review of relevant literature, including several meta-analyses of tympanoplasty outcome. RESULTS: Meta-analyses show that TEES tympanoplasty is as effective at closing tympanic membrane perforations and improving hearing as microscope-guided surgery. Yet patients benefit from avoidance of a skin incision and faster recovery. CONCLUSION: Repair of the tympanic membrane with TEES is feasible and effective. This minimally invasive approach is very appealing to patients.
BACKGROUND: Transcanal totally endoscopic ear surgery (TEES) has become increasingly popular internationally; however, for surgeons trained with a two-handed microscope-guided approach, the potential challenges of adopting TEES can appear off-putting. OBJECTIVES: This article outlines the pros and cons of TEES for tympanic membrane repair and describes aspects of surgical technique relevant to those who might adopt this approach. MATERIALS AND METHODS: Data are provided from the author's experience along with a review of relevant literature, including several meta-analyses of tympanoplasty outcome. RESULTS: Meta-analyses show that TEES tympanoplasty is as effective at closing tympanic membrane perforations and improving hearing as microscope-guided surgery. Yet patients benefit from avoidance of a skin incision and faster recovery. CONCLUSION: Repair of the tympanic membrane with TEES is feasible and effective. This minimally invasive approach is very appealing to patients.