ENDOSCOPIC EVALUATION OF THE MIDDLE EAR

DM. .Bui, TM. Bui M.D.

Westminster Ear Nose Throat Clinic

California, USA

Introduction: Evaluation of the middle ear with the operating microscope is most often unsatisfactory due to the inability of the light beam to reach deep recesses. Modern extra small and wide field Hopkins telescope with their oblique views could be used to visualize those critical hidden areas

Materials and methods: Endoscopy of the middle ear was performed first on a serie of 10 temporal bones then on a serie of 15 patients in conjunction with tympanoplasties. Different small Hopkins telescopes were used but the most useful was the 30° angle, 2.4mm diameter arthroscope. To be able to evaluate all areas of the middle ear, tympanoscopy was performed through the mesotympanum while mastoidoscopy and epitympanoscopy were performed through a small transcortical antrostomy.

Results: With endoscopy, all important areas of the middle ear were well visualized : facial recess sinus tympani , supratubal recess , aditus and epitympanum . There was no iatrogenic lesion to the dura, to the facial nerve or to the ossicles.