Abstract
We propose a novel technique—“underwater” endoscopic ear surgery (UWEES)—for preservation of inner ear function, especially in patients with a labyrinthine fistula, cochlear implantation, or other conditions requiring inner ear surgery. This technique provides a clear operative field without the need for suction and protects the inner ear from unexpected aeration that might lead to functional damage. The mastoid cavity or external auditory canal is filled completely by perfusion with saline or Ringer’s solution. The perfusate is delivered through a lens cleaning sheath covering an endoscope, thus providing a clear surgical field without reflection or refraction artifacts. This chapter describes the concept and indications for UWEES, the preparations that are necessary, the operative technique (including tips), cases we have treated, and details of training and possible future applications.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tarabichi M, Kapadia M. Principles of endoscopic ear surgery. Curr Opin Otolaryngol Head Neck Surg. 2016;24(5):382–7.
Alicandri-Ciufelli M, Federici G, Anschuetz L, et al. Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach. Eur Arch Otorhinolaryngol. 2017;274(9):3295–302.
Marchioni D, Alicandri-Ciufelli M, Gioacchini FM, et al. Transcanal endoscopic treatment of benign middle ear neoplasms. Eur Arch Otorhinolaryngol. 2013;270(12):2997–3004.
Preyer S. Endoscopic ear surgery – a complement to microscopic ear surgery. HNO. 2017;65(Suppl 1):29–34.
Copeland BJ, Buchman CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol. 2003;24:51–60.
Marcus DC. Acoustic transduction. In: Sperelakis N, editor. Cell physiology source book. 4th ed. Amsterdam: Elsevier; 2012. p. 649–68.
Kobayashi T, Sakurada T, Ohyama K, et al. Inner ear injury caused by air intrusion to the scala vestibuli of the cochlea. Acta Otolaryngol. 1993;113:725–30.
Pulec JL. Labyrinthine fistula from cholesteatoma: surgical management. Ear Nose Throat J. 1996;75(3):143–8.
Anagiotos A, Beutner D, Gostian AO, et al. Insertion of cochlear implant electrode array using the underwater technique for preserving residual hearing. Otol Neurotol. 2016;37(04):339–44.
Gaboyard S, Chabbert C, Travo C, et al. Three-dimensional culture of newborn rat utricle using an extracellular matrix promotes formation of a cyst. Neuroscience. 2005;133(1):253–65.
Yamauchi D, Yamazaki M, Ohta J, et al. Closure technique for labyrinthine fistula by “underwater” endoscopic ear surgery. Laryngoscope. 2014;124:2616–8.
Yamauchi D, Hara Y, Hidaka H, et al. How I do it: underwater endoscopic ear surgery for plugging in superior canal dehiscence syndrome. J Laryngol Otol. 2017;131(8):745–8.
Ito T, Kubota T, Takagi A, et al. Safety of heat generated by endoscope light sources in simulated transcanal endoscopic ear surgery. Auris Nasus Larynx. 2016;43(5):501–6.
El Kechai N, Agnely F, Mamelle E, et al. Recent advances in local drug delivery to the inner ear. Int J Pharm. 2015;494(1):83–101.
Nomura K, Oshima H, Yamauchi D, et al. Ototoxic effect of ultrastop antifog solution applied to the guinea pig middle ear. Otolaryngol Head Neck Surg. 2014;151(5):840–4.
Acknowledgement
We are grateful to Dr. Takuya Ito and Yuko Iki for support at Tohoku University Hospital Advanced Medical Training Center. This work was supported by KAKENHI (16K11171).
Conflict of Interest and Financial Disclosure
The authors have no funding, financial relationships, or conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Yamauchi, D., Honkura, Y., Hara, Y., Ohta, J., Hidaka, H., Katori, Y. (2020). Approach to the Inner Ear by “Underwater” Endoscopic Ear Surgery: Its Utilization and Prospects. In: Kakehata, S., Ito, T., Yamauchi, D. (eds) Innovations in Endoscopic Ear Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-13-7932-1_7
Download citation
DOI: https://doi.org/10.1007/978-981-13-7932-1_7
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-7931-4
Online ISBN: 978-981-13-7932-1
eBook Packages: MedicineMedicine (R0)