Endoscopic cartilage tympanoplasty: A two-handed technique using an endoscope holder.

OBJECTIVES/HYPOTHESIS: Endoscopic ear surgery provides a minimally invasive approach to the middle ear. The disadvantage of endoscopic ear surgery is that it is a single-handed surgical technique. The nondominant hand of the surgeon is utilized for holding and manipulating the endoscope. This necessitated the need for the development of an endoscope holder that would allow both hands to be free for surgical manipulation. The aim of this article is to report our preliminary experience using our newly designed and developed endoscope holder, which allowed us to perform cartilage tympanoplasty utilizing both hands for surgery.

STUDY DESIGN: Retrospective nonrandomized clinical study.

METHODS: The endoscope holder was designed and developed to aid in endoscopic ear surgery and to overcome the disadvantage of single-handed endoscopic surgery. The design of the endoscope holder is described in detail, along with instructions on how it can be used. A total of 179 endoscope holder-assisted cartilage tympanoplasties were performed to evaluate the feasibility of a two-handed technique and to evaluate the results of surgery.

RESULTS: In an early follow-up period ranging from 6 to 20 months, the graft take was seen in 174 ears, with one residual perforation and four recurrent perforations, giving a success rate of 97%. The endoscope holder eliminates the disadvantages of single-handed surgery and is a good option for those who wish to perform endoscopic ear surgery using both hands.

CONCLUSION: The study reports the successful application and use of the endoscope holder in a two-handed technique of endoscopic tympanoplasty.

LEVEL OF EVIDENCE: 4. Laryngoscope, 126:1893-1898, 2016.