Department of Otolaryngology-Head and Neck Surgery, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan, ROC.
School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
J Chin Med Assoc. 2023 May 1;86(5):523-528. doi: 10.1097/JCMA.0000000000000907. Epub 2023 Feb 28.
Exoscope has been used in otoneurologic surgery in several reports. However, most ear surgeries are performed using either microscope or endoscopy today. The purpose of this study is to present our subjective and objective experience of using this instrument in our institution.
Sixteen ears with different severity and condition in 15 consecutive patients were enrolled. A questionnaire with 12 questions was sent to different participants, including surgeons, residents, medical students, and scrub nurses in the operation room. The total score and average score of each item were calculated and analyzed.
Exclusive exoscopic operation was performed on 13 patients with 14 procedures. A combination of endoscopy-exoscope and microscope-exoscope was used in one patient, respectively. There were no complications. Hearing recovery or disease extirpation was achieved in most patients. Twenty participants in the operation room filled out the questionnaire. There was no significant difference between the different groups. High ratings were reported in terms of image quality, stereoscopic effects, magnification rate, and the same field of view as the surgeon. Worse ratings were reported in items related to limited working space, increase in eye strain by video observation, and focusing difficulty.
Exoscopic ear surgery is feasible, safe, and effective in managing various otologic conditions involving external ear, middle ear, mastoid, and lateral skull base. Its high-definition image quality, stereoscopic effects, sufficient magnification, reliability and teaching value made it a potential instrument in general ear surgeries. Further improvements to current drawbacks can be anticipated.
外窥镜已在几项耳神经外科学报告中被应用。然而，现今大多数耳部手术仍使用显微镜或内镜进行。本研究旨在呈现我们在机构中使用该器械的主观和客观经验。
连续 15 例患者的 16 只不同严重程度和状况的耳朵被纳入研究。我们向外科医生、住院医师、医学生和手术室护士等不同参与者发送了一份包含 12 个问题的问卷。计算并分析了每个项目的总分和平均分。
13 名患者进行了 14 次纯粹的外窥镜手术，一名患者分别进行了内镜-外窥镜和显微镜-外窥镜联合手术。无并发症发生。大多数患者的听力恢复或疾病得到了清除。20 名手术室参与者填写了问卷。不同组别之间无显著差异。报告的图像质量、立体效果、放大率和与外科医生相同的视野等方面评分较高。报告的较差项目包括工作空间有限、视频观察导致眼疲劳增加以及聚焦困难。
外窥镜耳部手术对于涉及外耳、中耳、乳突和侧颅底的各种耳科疾病是可行、安全且有效的。其高清图像质量、立体效果、充足的放大率、可靠性和教学价值使其成为普通耳部手术的潜在器械。目前的缺点可以进一步改进。
