Korean J Otorhinolaryngol-Head Neck Surg.  2019 Jul;62(7):367-378. 10.3342/kjorl-hns.2018.00570.

Safety and Effectiveness of Endoscopic Ear Surgery: Systematic Review

Affiliations
  • 1Division for New Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
  • 2Department of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Otorhinolaryngology, Korea University College of Medicine, Seoul, Korea.
  • 4Department of Preventive Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.
  • 5Department of Biomedical Engineering, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 6Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul, Korea. bdlee12@schmc.ac.kr

Abstract

BACKGROUND AND OBJECTIVES
This study aims to evaluate that usefulness of the endoscopic ear surgery (EES) through the systematic review.
SUBJECTS AND METHOD
We searched literatures in literature databases (MEDLINE, EMBASE, Cochrane Library, etc.). Inclusion criteria is 1) studies of patients with chronic otitis media, otitis media with effusion, cholesteatoma, conductive hearing loss, mixed hearing loss etc. 2) studies in which a transcanal endoscopic surgery was performed; and 3) studies in which one or more of the appropriate medical outcomes have been reported. We excluded that 1) non-human studies and pre-clinical studies; 2) non-original articles, for example, non-systematic reviews; editorial, letter and opinion pieces; 3) research not published in Korean and English; and 4) grey literature. Finally, 65 articles were selected and those results were analyzed.
RESULTS
The safety of the EES was reported in 61 articles. Some studies reported damaged facial nerve or perilymph gusher but these are the complications that can arise due to the characteristics of the disease and not due to the EES and other reported complications were of similar or lower level in the intervention group rather than the microscopy group. The effectiveness of the EES was reported in 23 articles. The EES tended to show improved effects in terms of graft uptake status, cholesteatoma removal, and hearing improvement although effective outcomes of most studies reported no significant difference between EES and microscopic ear surgery.
CONCLUSION
EES is a safe and effective technique and as it is less invasive than the microscopic ear surgery.

Keyword

Endoscope; Otologic surgical procedures; Otitis media; Cholesteatom; Hearing loss, Conductive

MeSH Terms

Cholesteatoma
Ear*
Endoscopes
Facial Nerve
Hearing
Hearing Loss, Conductive
Hearing Loss, Mixed Conductive-Sensorineural
Humans
Methods
Microscopy
Otitis Media
Otitis Media with Effusion
Otologic Surgical Procedures
Perilymph
Transplants
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