Endoscopic ear surgery, or "EES," is defined as the use of the rigid endoscope, in contrast to the operating roommicroscope, to visualize the middle and inner ear during otologicsurgery. During endoscopic ear surgery the surgeon holds the endoscope in one hand while working in the ear with the other. To allow this kind of single-handed surgery, different surgical instruments have to be used. Endoscopic visualization has improved due to high-definition video imaging and wide-field endoscopy, and being less invasive, EES is gaining importance as an adjunct to microscopic ear surgery.
History
Endoscopic Ear Surgery was first truly pioneered by Muaaz Tarabichi MD in Dubai during the late 90s. His contributions to the field have led to him being recognized globally as the father of endoscopic ear surgery. He now lecturers extensively on the topic worldwide. Similar to the early years of FESS, EES has been controversial since early descriptions in the 1960s. One of the benefits of an endoscope compared to the microscope is the wide-field view of the middle ear afforded by the location of the light source at the tip of the instrument and the availability of various types of angled lenses. Middle ear procedures that utilize a rigid endoscope for viewing may reduce the need to drill for enhanced exposure of the operative field. The traditional otologic operating microscopes typically require larger portals to enable adequate passage of light for intraoperative viewing and follow-up surveillance in the clinic. One handed dissection is cited as the main drawback to EES. The indications for this relatively new technique are evolving. The use of rigid endoscopes to perform ear surgery, rather than just to visualize the contents of the middle ear, is increasing as optimized instrumentation and operative approaches become available. Classification System: Class 0: Microscopic only case Class 1: Inspection with endoscope Class 2: Mixed dissection with endoscope and microscope Class 3: Endoscopic only case
