OTOENDOSCOPY-Reshma Ann Mathew

•Endoscopy means looking inside the body for medical reasons using an endoscope (instrument).

•Otoendoscopy is the endoscopy of the ear which involves placing a rigid endoscope into the ear to examine both the exterior and middle portions of the ear.

Oto-endoscope•An Otoendoscope is a short

rigid telescope usually of 10cm length and varying diameters- 1.7, 2.7, 3.4mm.

• It is available in 0, 30, 45, 70 degree angles.

• It has to be connected to a fiberoptic light source for illumination.

•The findings can be recorded through a camera.

•COMMONLY USED are 1.7mm 0˚ & 30˚

Types of Oto-Endoscopes 0 degree endoscope-The intact eardrum

can be examined closely and the movement of the ear drum evaluated.

30 degree endoscope- It can sometimes be passed through a perforated ear drum

-to determine the INTEGRITY of the tiny bones in the middle ear

-to DIAGNOSE disease in the hidden areas of the middle ear.

Sinus tympani, facial recess and eustachian tube are VISUALIZED.

45 degree

70 degree- The sinodural angle can be evaluated.

Uses1) The rigid photograph endoscopes have also been used for endoscopic transcanal myringoplasty. 2) The endoscope is passed through the

perforated ear drum to visualize the status of ossicles, eustachian tube orifice, tympanic membrane and the middle ear mucosa.

3) It can be used to remove tissue for biopsy.

Procedures performedoRemoval of granulations by crocodile

forceps and suctionoRemoval of epithelial debrisoRemoval of otomycotic flakesoRemoval of residual cholesteatomaoRemoval of foreign bodiesoRemoval of aural polypsoRemoval of necrosed meatal flapsoLowering of high facial ridge under local

anaesthesiaoPromotion of epithelization by application

of gentian violet to the cavity in case of delayed onset of epithelization

AdvantagesVisualizes the whole tympanic membrane

and the ear canal without having to manipulate the patient’s head or the microscope.

Extends the operative field in the transcanal procedures into structures usually hidden under the microscope

Visualizes structures from multiple angles as opposed to the microscope’s single axis along the ear canal.

Provides extremely sharp image with high resolution

Anatomical variations that hamper the view of entire tympanic membrane during ear surgery are overcome by otoendoscopy

Operative time and post-operative pain as well as morbidity are LESS

NO auricular displacement or numbness (a common side effect of post-auricular incision)

DisadvantagesFogging the lens of the endoscope, but

this can easily be handled by using an antifog solution

Smearing of blood on the tip of an otoendoscope during any procedures.

Otoendoscopy showing retracted ear drum draped around the middle ear structures

Otoendoscopic picture showing otomycosis

THANK YOU