Endoscope-assisted ear surgery.

Endoscopes deliver the otologic surgeon's view into the temporal bone to provide rapid access to its intricate recesses. The attic, sinus tympani, facial recess, hypotympanum, internal auditory canal, and other recesses are immediately visualized with angled endoscopes, using minimal exposure without the time-consuming removal of overlying bone. This report presents results of 32 otologic and neurotologic operations, performed since 1993, that incorporated endoscope-guided dissection as a principal part of the procedure to reduce incision size, exposure width, and operative time, or to access areas otherwise inaccessible. Included are endoscopic excision of acquired cholesteatoma without mastoidectomy, second-look mastoid procedures, mastoidectomy for biopsy (performed entirely endoscopically), and acoustic neuroma dissection from the lateral internal auditory canal. Endoscopic ear surgery is a valuable adjunct to conventional surgical techniques that require wider exposures and are limited to the direct line of sight.