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Introducing the High-definition 3D exoscope in ear surgery: preliminary analysis of advantages and limits compared with operative microscope

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the potential of 3D exoscope (EX) in selected ear procedures assessing if this new technology could be an improvement in the field of ear surgery.

Methods

A case series of consecutive patients surgically treated with a post-auricular approach using EX was retrospectively compared with a similar previous series treated with operating microscope (OM). Patient demographics, indications for surgery, procedure type, complications, operating room setting time (ORst), operative time, adequacy of visualization, image quality, ergonomics aspects, instrument usability, and technique as a teaching tool were investigated. Thirteen patients were included in each group. Surgical procedures in EX group were nine tympanoplasties with mastoidectomy, 1 mastoidectomy for acute complicated mastoiditis, 1 revision miringoplasty, and 2 cochlear implants. Same types of procedures were enrolled in OM group.

Results

No statistically significant difference was found between the two groups concerning ORst and operative time. In EX group, one complication occurred––a middle cranial fossa cerebrospinal fluid leak. Advantages of EX were lightness, maneuverability and compactness, less need of endoscopy during surgery, and teaching potential. Limits were a need of a large surgical corridor and the bright structures rendering in high magnification.

Conclusion

EX resulted safe and efficient in treating diseases of the middle ear in post-auricular approaches. To date, EX advantages are not enough to abandon the OM, and it can be considered as an additional, innovative tool to be added to ear surgical equipment.

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Availability of data and material

The authors confirm that the data supporting the findings of this study are available within the article.

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Acknowledgements

We thank Francesca Pirola, M.D. for the drawing of the operating room setting. We would also like to thank Dana Alon, M.D. for her help with the English language revision of the manuscript.

Funding

None declared.

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Humanitas Clinical and Research Center, IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy

    Giovanni Colombo, Fabio Ferreli, Matteo Di Bari, Giovanni Cugini, Stefano Miceli, Armando De Virgilio & Giuseppe Spriano

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy

    Giovanni Colombo, Fabio Ferreli, Matteo Di Bari, Armando De Virgilio & Giuseppe Spriano

  3. Department of Otolaryngology, American Hospital Dubai, Dubai, United Arab Emirates

    Arturo Poletti

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  1. Giovanni Colombo
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  2. Fabio Ferreli
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  3. Matteo Di Bari
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  4. Giovanni Cugini
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  5. Stefano Miceli
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  6. Armando De Virgilio
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  7. Giuseppe Spriano
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  8. Arturo Poletti
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Correspondence to Matteo Di Bari.

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Colombo, G., Ferreli, F., Di Bari, M. et al. Introducing the High-definition 3D exoscope in ear surgery: preliminary analysis of advantages and limits compared with operative microscope. Eur Arch Otorhinolaryngol 278, 4217–4223 (2021). https://doi.org/10.1007/s00405-020-06510-w

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  • DOI: https://doi.org/10.1007/s00405-020-06510-w

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