Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6267-6273. doi: 10.1007/s00405-024-08838-z. Epub 2024 Jul 24.
During endoscopic ear surgery (EES), it is important to maintain a clear view of the endoscopic camera to achieve a clean field. In this study, a self-expandable external auditory canal (EAC) retainer was developed to enable a more efficient and safer EES. This study aimed to evaluate the retainer's efficacy and safety in EES.
Among adult patients scheduled for endoscopic tympanoplasty, 50 participants were recruited. They were assigned to either the retainer or control group in a 1:1 ratio. The anatomical characteristics, number of endoscopic cleanings during surgery, surgeon's satisfaction, and other factors were evaluated.
No differences were observed in the surgical direction, EAC size measured on preoperative temporal bone computed tomography scans, location and size of tympanic membrane perforation, or bleeding degree between the two groups. When comparing the surgical time, including retainer insertion and removal, the time was similar between groups (retainer group, 35 min; control group, 33.2 min). The frequency of endoscopic cleaning per minute was statistically significantly lower in the retainer group than in the control group (0.18 times per minute, p = 0.048). No side effects, including sensory abnormalities or allergic reactions, were reported in any patient who used the retainer.
A reduction in unnecessary endoscopic cleaning during EES was observed while using the self-expandable retainer, leading to increased surgeon satisfaction and efficiency. Furthermore, as a safe method without side effects, the retainer could be widely used to various indications for EES beyond tympanoplasty.
在耳内镜手术(EES)中,保持内镜摄像头的清晰视野对于实现清洁术野非常重要。本研究开发了一种自膨式外耳道固定器,以实现更高效、更安全的 EES。本研究旨在评估该固定器在 EES 中的疗效和安全性。
纳入计划行内镜鼓膜成形术的成年患者,共 50 例,按 1:1 比例随机分为固定器组和对照组。评估解剖学特征、手术过程中内镜清洁次数、术者满意度等因素。
两组患者手术方向、术前颞骨 CT 测量的外耳道大小、鼓膜穿孔位置和大小、以及出血程度无差异。比较两组手术时间(包括固定器插入和移除时间),差异无统计学意义(固定器组 35 分钟,对照组 33.2 分钟)。固定器组内镜清洁频率每分钟明显低于对照组(0.18 次/分钟,p=0.048)。使用固定器的患者均未报告任何副作用,包括感觉异常或过敏反应。
使用自膨式固定器可减少 EES 过程中的不必要内镜清洁,提高术者满意度和效率。此外,作为一种安全、无副作用的方法,固定器可广泛应用于除鼓膜成形术之外的各种 EES 适应证。