Endoscopic ear surgery (EES): A new vista in otology

Aim Endoscopic Ear Surgery (EES) is increasingly being used both as an adjunct to surgery with a microscope and as a standalone procedure. Technological advancements such as high definition cameras and small diameter fibreoptics, allow superior quality images with a wider field of view. As with all new surgical procedures, there are advantages and disadvantages. We aim to share our experience of EES. Methods Following institutional ethical approval. We undertook a retrospective review of a consecutive cohort of patients (children and adults) who, between 2008-2019, underwent otologic surgery in our centre. Data was collected using theatre records and clinical notes. Results 2,062 procedures were included, 1,703 with binocular microscope and 359 EES procedures. The first EES procedures in our centre were carried out in 2013. Numbers and complexity have increased year on year; 2013 (3), 2019 (118). All EES were day case procedures and there were no major complications associated with the introduction of EES. EES procedures ranged from examination under anaesthesia to tympanoplasty, middle ear exploration and ossicular chain reconstruction. Conclusion EES uses the ear canal as an access port to the middle ear. With practice, more complex, totally endoscopic otologic surgeries may be carried out, targeting dysventilation, the fundamental cause of chronic ear disease and cholesteatoma. EES has proven to be a safe and valuable otologic procedure, facilitating high definition views of areas otherwise unseen.