Surgery for adhesive otitis media is generally known to be difficult; one reason is that a retracted tympanic membrane cannot be directly observed by microscopy. Moreover, elevation of a tympanic membrane which has adhered to the tympanic mucosa is difficult in a microscopic procedure. Recently, endoscopic ear surgery (EES) has been widely used for various middle ear diseases. The primary advantage of endoscopic procedures in ear surgeries is the wide field of view that allows visualization of lesions hidden behind bony structures. Thus, we have employed EES in the treatment of adhesive otitis media to take advantage of the improved visualization of a retracted or adhered tympanic membrane. EES allowed easy elevation of the adhered tympanic membrane from the facial recess, an area difficult to see directly by microscopy, with minimal removal of the bony edges. Complete elevation of the tympanic membrane from the ossicular chain, especially from the stapes, is also technically difficult by microscopic surgery. However, an endoscopic high-power view enables a clear and certain elevation procedure, which is helpful for preservation of the ossicular chain. Moreover, the clear, high-power endoscopic view enables the separation of the tympanic membrane adhesions from the tympanic mucosa, which is necessary to avoid re-adhesion.
Adhesive otitis media Tympanoplasty Endoscopic ear surgery (EES) Tympanic membrane Ossicular chain Cartilage tympanoplasty Retrotympanum Facial recess Sinus tympani
Adhesive otitis media
Endoscopic ear surgery
Magnetic resonance imaging
Otitis media with effusion
Transcanal endoscopic ear surgery
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The author is deeply grateful to Dr. Katsuki Niwa, Dr. Takaomi Kurioka, and Dr. Saki Takihata for their assistance.
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