Endoscopic ear surgery: A case series and first United Kingdom experience

Table 1 Summary of procedures

Procedure (including revision surgery)	Endoscopic assisted	Non-endoscopic assisted
	Group A	Group B
Ventilation Tube insertion	1	2
Myringoplasty, tympanoplasty, ossiculoplasty, Tympanotomy	10	10
CSOM and cholesteotoma surgery	15	10
Stapedectomy	11	9
Petrosectomy	1	1
Total	38	32

Table 2 Ventilation tube insertion

No.	Age	Side	Duration (min)	Previous ipsilateral surgery	Pre-op mean air-bone gap1	Post-op mean air-bone gap1	Closure	Follow up (mo)	Complications
Endoscopic assisted, Group A
1	15	R	25	No	22.5	0	Within 10-30 dB	4	None
Non-endoscopic assisted, Group B
1	14	R + L	20	No	25	10	Within 10-30 dB	9	None
2	53	R + L	15	No	20	20	No change	24	Recurrent otitis media with effusion

¹Mean gap calculated over 4 frequencies (500 Hz, 1 KHz, 2 KHz, 4 KHz).

Table 3 Myringoplasty, Tympanoplasty, Ossiculoplaty and Tympanotomy

No.	Age	Details	Side	Duration (min)	Previous ipsilateral surgery	Pre-op mean air-bone gap1	Post-op mean air-bone gap1	Closure	Graft material	Follow up (mo)	Complications
Endoscopic assisted, Group A
1	63	Myringoplasty	R	66	Yes	Dead ear	Dead ear	No change	Conchal cartilage	1	Tragal abscess and otitis externa
2	37	Myringoplasty	L	60	No	15.5	12.5	No change	Temporalis fascia	4	None
3	55	Myringoplasty	L	45	Yes	5	5	No change	Composite tragal graft	4	None
4	16	Revision myringoplasty	R	45	Yes	0	0	No change	Tragal cartilage	5	None
5	22	Tympanoplasty	R	88	No	0	0	No change	Composite tragal graft	12	None
6	45	Tympanoplasty	L	101	Yes	20	15	Within 10-30 dB	Tragal cartilage	4	None
7	32	Tympanoplasty	L	98	No	7.5	6.25	Within 10 dB	Tragal cartilage	2	None
8	46	Tympanoplasty	L	111	Yes	18.75	23.3	No change	Tragal cartilage	2	None
9	35	Tympanoplasty	R	121	No	30	11.25	Within 10 dB	Not stated	3	None
10	34	Ossiculoplasty	R	123	Yes	42.5	12.5	Within 10-30 dB	Not stated	10	None
Non-endoscopic assisted, Group B
1	12	Myringoplasty	R	55	No	12.5	11.25	Within 10-30 dB	5	5	None
2	9	Myringoplasty	L	130	No	27.5	Not available	Not available	Temporalis fascia	Lost to follow up
3	30	Revision myringoplasty	L	97	No	16.25	15	Within 10-30 dB	Temporalis fascia	12	None
4	66	Tympanoplasty	L	127	Yes	Not available	Not available	Not available	Not stated	5	Will need ossiculoplasty
5	59	Tympanoplasty	L	114	No	15	40	> 30 dB	Not stated	4	Scarring, false fundus recurrence
6	33	Tympanoplasty	L	174	No	Dead	Dead	No change	Composite tragal graft	5	None
7	10	Tympanoplasty	L	88	No	23.75	21.25	Within 10-30 dB	Temporalis fascia	3	None
8	21	Tympanoplasty	R	92	No	16.25	6.25	Overclosure	Temporalis fascia	10	None
9	63	Tympanoplasty	R	100	No	Dead	Dead	No change	Not stated	3	None
10	50	Revision tympanoplasty	R	101	Yes	0	20	> 30 dB	Tragal cartilage	2	None

¹Mean gap calculated over 4 frequencies (500 Hz, 1 KHz, 2 KHz, 4 KHz).

Table 4 CSOM and cholesteatoma surgery

No.	Age	Details	Side	Duration (min)	Previous ipsilateral surgery	Pre-op mean air-bone gap1	Post-op mean air-bone gap1	Closure	Graft material	Follow up (mo)	Complications
Endoscopic assisted, Group A
1	42	Mastoidectomy	L	211	No	7.5	7.5	No change	Temporalis fascia	6	None
2	40	Revision mastoidectomy	R	155	Yes	40	40	No change	Not stated	3	None
3	7	Tympanoplasty and mastoid exploration	L	169	Yes	13.75	5	Overclosure	Conchal cartilage	3	None
4	35	Tympanotomy	L	48	No	25	25	No change	Not stated	2	None
5	18	CWU mastoidectomy	L	195	No	7.5	17.5	Within 10 dB	Conchal cartilage	7	None
6	52	CWU mastoidectomy	L	287	Yes	20	18.75	> 30 dB	Tragal cartilage	6	None
7	13	Revision CWU mastoidectomy	L	188	Yes	11	25	> 30 dB	Tragal cartilage	2	None
8	47	MR mastoidectomy	R	287	No	27.5	23.75	Within 10-30 dB	Not stated	2	None
9	40	MR mastoidectomy	L	223	Yes	Data unavailable	16.25	Within 10-30 dB	Tragal cartilage	2	Post op. pain
10	28	Revision MR mastoidectomy	L	228	Yes	21.25	21.25	No change	Not stated	4	None
11	41	Revision MR mastoidectomy	L	140	Yes	31.25	31.25	No change	Not stated	4	None
12	35	Revision MR mastoidectomy	R	95	Yes	42.5	42.5	No change	Not stated	6	None
13	85	Revision MR mastoidectomy	L	110	Yes	20	20	No change	Not stated	11	None
14	68	Revision MR mastoidectomy	L	155	Yes	45	50	No change	Temporalis fascia	3	None
15	43	Revision MR mastoidectomy		78	Yes	Dead ear	Dead ear	No change	Not stated	4	Transient delayed facial palsy
Non-endoscopic assisted, Group B
1	8	CWU mastoidectomy	L	220	No	17.5	12.5	Within 10-30 dB	Temporalis fascia	12	None
2	52	CWU mastoidectomy	L	286	No	27.5	25	> 30 dB	Not stated	7	None
3	13	Revision CWU mastoidectomy	L	189	Yes	7.5	30	Within 10-30 dB	Tragal cartilage	5	None
4	70	MR mastoidectomy	L	131	No	13.75	20	> 30 dB	Composite tragal graft	3	None
5	42	MR mastoidectomy	R	255	No	28.75	35	> 30 dB	Temporalis fascia	3	None
6	34	MR mastoidectomy	R	312	No	33.75	37.5	> 30 dB	Composite tragal graft	2	None
7	73	Revision MR mastoidectomy	L	150	Yes	Dead ear	Dead ear	No change	Tragal cartilage	9	None
8	77	Revision MR mastoidectomy	L	179	Yes	2.5	21.25	Within 10-30 dB	Tragal Cartilage	8	None
9	56	Revision MR mastoidectomy	L	251	No	20	10	Within 10-30 dB	Temporalis ascia	4	None
10	78	Revision MR mastoidectomy	R	199	No	Dead ear	Dead ear	No change	Not stated	6	None

¹Mean gap calculated over 4 frequencies (500 Hz, 1 KHz, 2 KHz, 4 KHz). CWU: Canal wall up mastoidectomy; MR: Modified radical mastoidectomy.

Table 5 Stapedectomy

No.	Age	Details	Side	Duration (min)	Previous ipsilateral surgery	Pre-op mean air-bone gap1	Post-op mean air-bone gap1	Closure	Prosthesis	Follow up (mo)	Complications
Endoscopic Assisted, Group A
1	30	Stapedectomy	L	149	No	28.75	10	Overclosure	SMart piston	9	None
2	57	Stapedectomy	L	119	No	11.25	15	Within 10-30 dB	SMart piston	3	None
3	43	Stapedectomy	R	137	No	35	6.25	Within 10-30 dB	SMart piston	6	None
4	44	Stapedectomy	R	145	No	32.5	10	Within 10-30 dB	SMart piston	4	None
5	32	Stapedectomy	R	150	No	25	26.25	No change	Plastipore PORP	5	None
6	39	Stapedectomy	R	115	No	40	13.75	Within 10 dB	PORP	3	None
7	45	Stapedectomy	R	151	No	38.75	40	Overclosure	Porphexpiston	2	Infection in mastoid cavity
8	33	Stapedectomy	R	125	No	13.75	6.25	Overclosure	SMart piston	5	None
9	37	Revision stapedctomy	L	139	Yes	25	17.5	Within 10 dB	SMart piston	8	None
10	32	Revision stapedectomy	L	142	Yes	60	60	No change	SMart piston	2	Labyrinthitis
11	47	Revision revision stapedectomy	R	129	Yes	16.25	20	Within 10-30 dB	SMart piston	7	None
Non-endoscopic Assisted, Group B
1	48	Stapedectomy	R	254	No	45	7.5	< 10 dB	fluoroplastic piston	11	None
2	44	Stapedectomy	R	230	No	21.25	Not available	n/a	Fluoroplastic piston	Lost to follow up
3	45	Stapedectomy	L	118	No	26.25	8.75	< 10 dB	Smart piston	5	None
4	41	Stapedectomy	R	265	No	37.5	13.75	Within 10-30 dB	Smart piston	3	None
5	41	Stapedectomy	L	253	No	33.75	16.25	Within 10-30 dB	Smart piston	13	None
6	42	Stapedectomy	L	98	No	32.5	20	Overclosure	Fluoroplastic piston	22	None
7	40	Stapedectomy	L	169	No	40	5	< 10 dB	Fluoroplastic piston	14	None
8	56	Revision stapedectomy	L	111	Yes	20	10	< 10 dB	Fluoroplastic piston	5	None
9	38	Revision stapedectomy	R	79	Yes	26.25	21.25	> 30 dB	Fluoroplastic piston	8	Planned for revision revision surgery

¹Mean gap calculated over 4 frequencies (500 Hz, 1 KHz, 2 KHz, 4 KHz). PORP: Partial ossicular replacement prosthesis; n/a: Not Applicable.

Table 6 Petrosectomy

No.	Age	Side	Duration (min)	Previous ipsilateral surgery	Pre-op mean air-bone gap1	Post-op mean air-bone gap1	Closure	Graft material	Follow up (mo)	Complications
Endoscopic assisted, Group A
1	63	R	387	No	Dead ear	Dead ear	No change	Fat, Fascia lata	3	Intraoperative CSF leak; TM perforation
Non-endoscopic assisted, Group B
1	79	R	253	No	Dead ear	90	No change	Not stated	6	referral for cochlear implant

¹Mean gap calculated over 4 frequencies (500 Hz, 1 KHz, 2 KHz, 4 KHz). CSF: Cerebrospinal fluid; TM: Tympanic membrane.