Micro-endoscopy of the eustachian tube using a 2.0 mm flexible endoscope: technique, anatomical insights, and clinical outcomes.

OBJECTIVE

To describe a step-by-step approach for micro-endoscopy of the Eustachian tube (ET) using a 2.0 mm flexible endoscope and evaluate its efficacy in visualizing anatomical structures and assessing functional pathology in patients with chronic ear disease.

METHODS

A prospective study was conducted on 20 patients (12 males, 8 females; mean age 45.2 years) presenting with ET dysfunction or chronic otitis media. Under local anesthesia, transnasal-transpharyngeal videoendoscopy was performed using a 2.0 mm. The procedure targeted the pharyngeal ostium, cartilaginous lumen, isthmus region, and middle ear cavity. Anatomical visualization, procedural tolerability, and pathological findings were recorded.

RESULTS

The 2.0 mm endoscope successfully visualized the pharyngeal ostium and cartilaginous lumen in all cases (100%), with clear assessment of tubal cartilage mobility. Passage through the isthmus was achieved in 85% of cases, allowing middle ear access. Normal findings were observed in 60% of tubes, while 40% showed pathologies such as mucosal edema or stenosis. The procedure was well-tolerated, with additional anesthesia required in 30% of patients. No complications occurred.

CONCLUSION

Micro-endoscopy with a 2.0 mm flexible endoscope offers a safe, minimally invasive method for detailed ET evaluation, bridging the gap between larger rigid scopes and ultrafine fiberscopes. It enhances diagnostic accuracy for ET-related disorders and supports targeted interventions.