耳科領域における内視鏡下診療

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  • Endoscopic Observation and Treatment for the Ear Diseases
  • ジカ リョウイキ ニ オケル ナイシキョウ カ シンリョウ

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Endoscopic observation and treatment have been remarkably developed in so many fields of the medicine, because they are very clear to observe local disease and no traumatic. In otolaryngology, what is the reason that endoscopic application is very popular in rhinology and unpopular in otology? Working space may be important factor for limited use of endoscope in narrow external ear canal and middle ear. Another reason may be difficult operative skill to introduce an endoscopic ear surgery.<br>Our ear surgeon holds an endoscope with 2.7 or 4 mm diameter and 17 cm long in the left hand and handles surgical tools in the right hand. Both two devices are introduced into the middle ear through the external ear canal.<br>Merit of endoscopic-aided ear surgery is that its observation can give a full and clearly view of the middle ear cleft. Detailed observation can avoid an injury of the facial nerve or the inner ear. Moreover, endoscope can show a residual cholesteatoma under the ossicles or in the tympanic sinus which lesion might not be found with a microscopic observation. Therefore, an endoscope should be introduced more and more for ear surgery, especially in case of children. The anatomical feature may cause ear surgeon to hesitate the use of an endoscope in children. We have performed an endoscope-aided ear surgery in children for the last three years and endoscope was possible to apply for safe operation in every case of children.<br>Our conclusion is that endoscope should be used more in daily ear clinic for accurate diagnosis of ear disease and in ear surgery for safe operation with full view of middle ear cavity and to avoid residual disease.

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