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Approach to the Inner Ear by “Underwater” Endoscopic Ear Surgery: Its Utilization and Prospects

  • Daisuke YamauchiEmail author
  • Yohei Honkura
  • Yosuke Hara
  • Jun Ohta
  • Hiroshi Hidaka
  • Yukio Katori
Chapter
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Abstract

We propose a novel technique—“underwater” endoscopic ear surgery (UWEES)—for preservation of inner ear function, especially in patients with a labyrinthine fistula, cochlear implantation, or other conditions requiring inner ear surgery. This technique provides a clear operative field without the need for suction and protects the inner ear from unexpected aeration that might lead to functional damage. The mastoid cavity or external auditory canal is filled completely by perfusion with saline or Ringer’s solution. The perfusate is delivered through a lens cleaning sheath covering an endoscope, thus providing a clear surgical field without reflection or refraction artifacts. This chapter describes the concept and indications for UWEES, the preparations that are necessary, the operative technique (including tips), cases we have treated, and details of training and possible future applications.

Keywords

Labyrinthine fistula Chronic otitis media Cochlear implantation Drug delivery system Endoscopic ear surgery Underwater 

Notes

Acknowledgement

We are grateful to Dr. Takuya Ito and Yuko Iki for support at Tohoku University Hospital Advanced Medical Training Center. This work was supported by KAKENHI (16K11171).

Conflict of Interest and Financial Disclosure

The authors have no funding, financial relationships, or conflicts of interest to disclose.

References

  1. 1.
    Tarabichi M, Kapadia M. Principles of endoscopic ear surgery. Curr Opin Otolaryngol Head Neck Surg. 2016;24(5):382–7.CrossRefGoogle Scholar
  2. 2.
    Alicandri-Ciufelli M, Federici G, Anschuetz L, et al. Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach. Eur Arch Otorhinolaryngol. 2017;274(9):3295–302.CrossRefGoogle Scholar
  3. 3.
    Marchioni D, Alicandri-Ciufelli M, Gioacchini FM, et al. Transcanal endoscopic treatment of benign middle ear neoplasms. Eur Arch Otorhinolaryngol. 2013;270(12):2997–3004.CrossRefGoogle Scholar
  4. 4.
    Preyer S. Endoscopic ear surgery – a complement to microscopic ear surgery. HNO. 2017;65(Suppl 1):29–34.CrossRefGoogle Scholar
  5. 5.
    Copeland BJ, Buchman CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol. 2003;24:51–60.CrossRefGoogle Scholar
  6. 6.
    Marcus DC. Acoustic transduction. In: Sperelakis N, editor. Cell physiology source book. 4th ed. Amsterdam: Elsevier; 2012. p. 649–68.CrossRefGoogle Scholar
  7. 7.
    Kobayashi T, Sakurada T, Ohyama K, et al. Inner ear injury caused by air intrusion to the scala vestibuli of the cochlea. Acta Otolaryngol. 1993;113:725–30.CrossRefGoogle Scholar
  8. 8.
    Pulec JL. Labyrinthine fistula from cholesteatoma: surgical management. Ear Nose Throat J. 1996;75(3):143–8.CrossRefGoogle Scholar
  9. 9.
    Anagiotos A, Beutner D, Gostian AO, et al. Insertion of cochlear implant electrode array using the underwater technique for preserving residual hearing. Otol Neurotol. 2016;37(04):339–44.PubMedGoogle Scholar
  10. 10.
    Gaboyard S, Chabbert C, Travo C, et al. Three-dimensional culture of newborn rat utricle using an extracellular matrix promotes formation of a cyst. Neuroscience. 2005;133(1):253–65.CrossRefGoogle Scholar
  11. 11.
    Yamauchi D, Yamazaki M, Ohta J, et al. Closure technique for labyrinthine fistula by “underwater” endoscopic ear surgery. Laryngoscope. 2014;124:2616–8.CrossRefGoogle Scholar
  12. 12.
    Yamauchi D, Hara Y, Hidaka H, et al. How I do it: underwater endoscopic ear surgery for plugging in superior canal dehiscence syndrome. J Laryngol Otol. 2017;131(8):745–8.CrossRefGoogle Scholar
  13. 13.
    Ito T, Kubota T, Takagi A, et al. Safety of heat generated by endoscope light sources in simulated transcanal endoscopic ear surgery. Auris Nasus Larynx. 2016;43(5):501–6.CrossRefGoogle Scholar
  14. 14.
    El Kechai N, Agnely F, Mamelle E, et al. Recent advances in local drug delivery to the inner ear. Int J Pharm. 2015;494(1):83–101.CrossRefGoogle Scholar
  15. 15.
    Nomura K, Oshima H, Yamauchi D, et al. Ototoxic effect of ultrastop antifog solution applied to the guinea pig middle ear. Otolaryngol Head Neck Surg. 2014;151(5):840–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Daisuke Yamauchi
    • 1
    Email author
  • Yohei Honkura
    • 1
  • Yosuke Hara
    • 1
  • Jun Ohta
    • 1
  • Hiroshi Hidaka
    • 1
  • Yukio Katori
    • 1
  1. 1.Department of Otolaryngology-Head and Neck SurgeryTohoku University, Graduate School of MedicineSendaiJapan

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