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3D exoscopic surgery of lateral skull base

  • Alessia Rubini
  • Stefano Di GioiaEmail author
  • Daniele Marchioni
Otology
  • 30 Downloads

Abstract

Purpose

The aim of the study is to assess whether the 3D exoscopic surgery technique could be used in lateral skull base surgery and if it could ultimately replace the microscope in the future.

Methods

This is a retrospective study in which were included 24 patients affected by lateral skull base pathologies, who underwent surgery using the 3D exoscope or the operative microscope at the Department of Otolaryngology—Head and Neck Surgery at the University Hospital of Verona. The exoscope and microscope groups each included 12 cases. The feasibility of all the surgical steps solely using the 3D exoscope was evaluated. The exoscope group and microscope group were compared taking into account the following factors: time of the surgery, facial and hearing functions outcomes, as well as the intraoperative and postoperative complications.

Results

No intraoperative complication occurred during all the procedures. Postoperatively, only one minor complication emerged. The average operative time was 289 in the exoscope group and 313 min in the microscope one. No significant statistical differences were identified between the two groups (p > 0.05). The facial and hearing function outcomes were fully comparable.

Conclusion

Our experience demonstrated that the exclusive use of the 3D exoscope, as that of the traditional microscope during lateral skull base surgery, is feasible for all open approaches. The use of the 3D exoscopic technique is very promising for future lateral skull base surgeries.

Keywords

Lateral skull base Exoscope Exoscope 3D Microscope Translabyrinthine Subtotal petrosectomy Vestibular schwannoma Petrous apex surgery Cholesteatoma 

Notes

Author contributions

All of the authors have read and approved the manuscript.

Compliance with ethical standards

Conflict of interest

The present authors have no financial relationship to disclose.

References

  1. 1.
    House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93(2):146–147CrossRefGoogle Scholar
  2. 2.
    Rossini Z et al (2017) VITOM 3D: preliminary experience in cranial surgery. World Neurosurg 107:663–668CrossRefGoogle Scholar
  3. 3.
    Kwan K et al (2018) Lessons learned using a high-definition 3-dimensional exoscope for spinal surgery. Oper Neurosurg (Hagerstown) 16(5):619–625CrossRefGoogle Scholar
  4. 4.
    Sack J et al (2018) Initial experience using a high-definition 3-dimensional exoscope system for microneurosurgery. Oper Neurosurg (Hagerstown) 14(4):395–401CrossRefGoogle Scholar
  5. 5.
    Beez T et al (2018) First clinical applications of a high-definition three-dimensional exoscope in pediatric neurosurgery. Cureus 10(1):e2108PubMedPubMedCentralGoogle Scholar
  6. 6.
    Belykh E et al (2018) Microvascular anastomosis under 3D exoscope or endoscope magnification: a proof-of-concept study. Surg Neurol Int 9:115CrossRefGoogle Scholar
  7. 7.
    Garneau JC et al (2019) The use of the exoscope in lateral skull base surgery: advantages and limitations. Otol Neurotol 40(2):236–240CrossRefGoogle Scholar
  8. 8.
    Smith S et al (2019) Initial experience with 3-dimensional exoscope-assisted transmastoid and lateral skull base surgery. Otolaryngol Head Neck Surg 160(2):364–367CrossRefGoogle Scholar
  9. 9.
    Berguer R (1999) Surgery and ergonomics. Arch Surg 134(9):1011–1016CrossRefGoogle Scholar
  10. 10.
    Bourne SK et al (2013) Neurological surgery: the influence of physical and mental demands on humans performing complex operations. J Clin Neurosci 20(3):342–348CrossRefGoogle Scholar
  11. 11.
    Zdichavsky M et al (2015) Three-dimensional laparoscopy and thoracoscopy in children and adults: a prospective clinical trial. Minim Invasive Ther Allied Technol 24(3):154–160CrossRefGoogle Scholar
  12. 12.
    Kong SH et al (2010) Comparison of two- and three-dimensional camera systems in laparoscopic performance: a novel 3D system with one camera. Surg Endosc 24(5):1132–1143CrossRefGoogle Scholar
  13. 13.
    Kim SH et al (2013) Influence of stereopsis and abnormal binocular vision on ocular and systemic discomfort while watching 3D television. Eye (Lond) 27(11):1243–1248CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Alessia Rubini
    • 1
  • Stefano Di Gioia
    • 1
    Email author
  • Daniele Marchioni
    • 1
  1. 1.Otolaryngology-Head and Neck Surgery DepartmentUniversity Hospital of VeronaVeronaItaly

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