Endoscopic Ear Surgery

James Prueter, DO
Southwest Ohio ENT Specialists

The ear is made of three parts; the external, middle and inner ear. Most outpatient surgery is done in the middle ear space. This space is very small and contains many critical structures. The primary space containing structures are the middle ear bones; known as the malleus, incus and stapes. The middle ear also contains the facial nerve, chorda tympani nerve and it abuts the inner ear which contains the cochlear and vestibular systems.

Historically, and currently, microscopes are used for ear surgery. Microscopes are used to magnify this very small anatomy. Since the lens of the microscope is away from the patient, often times larger incisions are necessarily made to allow the light, and field of view of the surgeon, to reach the critical structures. The microscope is widely accepted and often used in combination with endoscopes.

Endoscopic ear surgery (also known as transcanal endoscopic ear surgery or TEES) utilizes advances in camera and optical technology to provide extremely high-definition video with a wide-angle field of view. The difference between microscopic and endoscopic ear surgery is that the surgeon is able to visualize areas of the ear space that cannot be seen with the microscope. The endoscope also allows greater visibility due to the location of the light and lens. The tip of the endoscope contains the light source which is in the middle ear space whereas the microscope light source is about a foot away and can easily be blocked causing shadows or direct obstruction.

Endoscopic ear surgery is performed to treat; tympanic membrane perforations, ossicular chain reconstruction, stapedectomy, removal of cholesteatoma and removal of other middle ear tumors.

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