Transcanal Endoscopic Ear Surgery - Types, Benefits, and Complications

Introduction

Ears are tiny and tender structures that could be easily damaged due to an injury. Performing surgical procedures could be a tedious task as the inner parts of the ear are very minute. Traditional ear surgeries could result in scarring and may be painful. The advancement in technology has aided surgeons in performing ear surgery precisely with the help of an endoscope. An endoscope is a tiny tube-like structure that has a camera fitted in one end, which helps to view the internal structures of the ear, like the tympanic membrane and ear ossicles, accurately. This enables the surgeon to perform the surgery with more accuracy.

What Is Ear Surgery?

Otoplasty or ear surgery are similar terms that indicate a surgical procedure to correct the shape, position, and proportion of the ears. It is usually performed to improve the ear's appearance and to correct any acquired or congenital ear defects that affect the functions of the ear. It also includes correcting the prominent or misshapen ears, repairing torn earlobes, correcting the ear deformities that were caused due to injury, and correcting hearing problems.

What Are the Types of Ear Surgery?

Ear surgery can be broadly classified into various types, which are mentioned below:

• Otoplasty - It is the most common type of ear surgery that involves shaping and repositioning the ears to create a more aesthetically pleasing appearance.

• Stapedectomy - This procedure is meant to treat hearing loss, which may be caused due to stiffening of the stapes bone in the middle ear.

• Earlobe Surgery - It is a procedure to repair torn or stretched ear lobes, which could be caused by an injury or piercing ears.

• Ear Pinning - It is also called setback surgery. In this procedure, the ears are moved closer to the head to reduce the prominent appearance.

• Surgery for Congenital Ear Deformities - This type of ear surgery is typically done to correct birth defects that affect the shape, size, and position of ears, like in microtia (underdeveloped ears).

What Is Transcanal Endoscopic Ear Surgery?

A minimally invasive surgical method to treat certain medical conditions that affect the middle and inner ear is called transcanal endoscopic ear surgery. The procedure involves using a small endoscope, which is a flexible tube with a light and a camera that visualizes and aids in accessing the inner ear via the ear canal. This technique helps the surgeon to perform various procedures without making an incision in the external ear or without opening the mastoid bone.

This surgery is primarily used for conditions like otitis media (inflammation of the middle ear), cholesteatoma (non-cancerous growth of the middle ear), and ossicular chain reconstruction (repair of the bones of the middle ear). It is potentially beneficial in reducing surgical trauma, minimizing the scarring, and improving the recovery time when compared to traditional open-ear surgery. Not all conditions can be treated using transcanal endoscopic ear surgery, and it may not be suitable for everyone. The doctor makes the decision to determine the type of approach, depending on the type of condition.

What Are the Uses of Transcanal Endoscopic Ear Surgery?

The following procedures can be performed with transendoscopic ear surgery:

• Stapedectomy (surgery done to improve hearing).

• Ossiculoplasty (Reconstructing the ear ossicles).

• Tumor removal.

• Tympanoplasty (surgery to promote healing of ear drums).

• Cyst drainage.

What Are the Benefits of Transcanal Endoscopic Ear Surgery?

Transcanal endoscopic ear surgery has several benefits, which are listed below.

• Improved Visualization - The endoscope provides a clear view of the inner ear, which helps the surgeon view the anatomical structures and perform the surgery with greater precision.

• Minimally Invasive - The surgery is performed through the ear canal, which indicates that no external incision will be required. This helps in reducing surgical trauma and scarring.

• Faster Recovery - Endoscopic ear surgery has a faster recovery when compared to traditional open ear surgery as it is less invasive.

• Reduced Post-operative Pain - As the procedure is minimally invasive, many patients experience less pain and discomfort after the surgery.

• Lower Risk of Complications - Reduced surgical trauma helps to improve visualization, which results in a lower risk of complications like bleeding, infection, and injury to the surrounding structures.

However, transcanal endoscopic ear surgery is not suitable for all conditions and may not be the best option for everyone.

What Are the Disadvantages of Transcanal Endoscopic Ear Surgery?

Transcanal endoscopic surgery is a relatively new surgical technique and has several potential disadvantages.

• Limited Applicability - Ear surgery is not suitable for all medical conditions, and some conditions may require traditional open-ear surgery.

• Technical Difficulty - Performing transcanal endoscopic ear surgery could be extremely challenging and requires specialized equipment and a highly trained surgeon.

• High Cost - The surgery can be comparatively more expensive than traditional open ear surgery due to the specialized equipment and trained surgeons required.

• Lack of Long-term Data - It is a relatively new technique and may be limited long-term data available on its outcomes and effectiveness.

• Risk of Injury - The inner ear structures are minimally invasive, and there could be a risk of injury to the delicate inner parts of the ear during the surgery.

It is important to carefully consider the potential benefits of the risk of the surgery before making the decision. It is better to consult the doctor for various options to identify the appropriate approach that best suits the surgery.

What Are the Complications of Transcanal Endoscopic Ear Surgery?

Some of the complications of transcanal ear surgery include the following:

• Sensorineural hearing loss (hearing loss caused due to damage in the inner ears).

• Postoperative tympanic membrane perforation (injury in the connection between external and middle ear).

• Labyrinthine fistula (abnormal communication between the inner ear and surrounding structures).

• Chorda tympani interruption (damage to the nerve carrying taste sensation).

• Facial nerve paralysis (loss of movements in the facial muscle).

• Accidental ossicular chain disruption (separation of middle ear bones).

• Infection.

• Dizziness.

• Vertigo.

• Perforation of the eardrum.

• Adverse reaction to anesthesia.

• Nerve damage.

The potential complications of the surgery should be primarily discussed with the doctor before proceeding with transcanal endoscopic ear surgery.

Conclusion

Transcanal ear surgery is beneficial in treating various ear deformities as it causes less scarring and damage to the ears. Post-surgery, the patient has to be carefully monitored for complications. Although the surgery is expensive when compared to conventional ear surgery, there are various advantages that help with better healing and less discomfort to the patient.