Ridge Sarah E, Shetty Kunal R, Lee Daniel J
Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
World J Otorhinolaryngol Head Neck Surg. 2021 Feb 6;7(2):101-108. doi: 10.1016/j.wjorl.2020.09.003. eCollection 2021 Apr.
There has been a rapid increase in endoscopic ear surgery for the management of middle ear and lateral skull base disease in children and adults over the last decade. In this review paper, we discuss the current trends and applications of the endoscope in the field of otology and neurotology. Advantages of the endoscope include excellent ergonomics, compatibility with pediatric anatomy, and improved access to the middle ear through the external auditory canal. Transcanal endoscopic ear surgery has demonstrated comparable outcomes in the management of cholesteatoma, tympanic membrane perforations, and otosclerosis as compared to microscopic approaches, while utilizing less invasive surgical corridors and reducing the need for postauricular incisions. When a postauricular approach is required, the endoscopic-assisted transmastoid approach can avoid a canal wall down mastoidectomy in cases of cholesteatoma. The endoscope also has utility in treatment of superior canal dehiscence and various skull base lesions including glomus tumors, meningiomas, and vestibular schwannomas. Outside of the operating room, the endoscope can be used during examination of the outer and middle ear and for debridement of complex mastoid cavities. For these reasons, the endoscope is currently poised to transform the field of otology and neurotology.
在过去十年中，用于治疗儿童和成人中耳及侧颅底疾病的耳内镜手术迅速增加。在这篇综述文章中，我们讨论了耳内镜在耳科学和神经耳科学领域的当前趋势及应用。耳内镜的优点包括出色的人体工程学设计、与儿童解剖结构的兼容性，以及通过外耳道改善对中耳的观察。与显微镜手术相比，经耳道耳内镜手术在胆脂瘤、鼓膜穿孔和耳硬化症的治疗中已显示出相当的疗效，同时采用侵入性较小的手术路径并减少了耳后切口的需求。当需要耳后入路时，耳内镜辅助经乳突入路可避免在胆脂瘤病例中行开放式乳突根治术。耳内镜在治疗上半规管裂及各种颅底病变（包括颈静脉球体瘤、脑膜瘤和前庭神经鞘瘤）方面也有应用价值。在手术室之外，耳内镜可用于检查外耳和中耳以及清理复杂的乳突腔。基于这些原因，耳内镜目前有望改变耳科学和神经耳科学领域。
