Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-08T05:23:16.809Z Has data issue: false hasContentIssue false
  • English
  • Français

Middle-ear endoscopy and trans-tympanic drug delivery using an interventional sialendoscope: feasibility study in human cadaveric temporal bones

Published online by Cambridge University Press:  02 June 2010

G Peters ,
J Lin ,
M A Arriaga ,
D W Nuss ,
B Schaitkin  and
R R Walvekar
G Peters
Affiliation:
Department of Otolaryngology Head Neck Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana, USA
J Lin
Affiliation:
Department of Otolaryngology Head Neck Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana, USA
M A Arriaga
Affiliation:
Department of Otolaryngology Head Neck Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana, USA
D W Nuss
Affiliation:
Department of Otolaryngology Head Neck Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana, USA
B Schaitkin
Affiliation:
Department of Otolaryngology Head Neck Surgery, University of Pittsburgh, Pennsylvania, USA
R R Walvekar*
Affiliation:
Department of Otolaryngology Head Neck Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana, USA
*
Address for correspondence: Dr Rohan R Walvekar, Assistant Professor, Department of Otolaryngology Head Neck Surgery, LSU Health Sciences Center, 533 Bolivar St, Suite 557, New Orleans, LA 70112, USA. Fax: + 1 (504) 568 4460 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to assess the feasibility of using a 1.3 mm, semi-rigid, interventional salivary endoscope for middle-ear endoscopy, and as a trans-tympanic route for delivery of medication, in human cadaveric temporal bones.

Study design:

Human cadaveric study.

Methods:

Five temporal bones harvested from human cadavers were examined. A 1.3 mm, interventional sialendoscope was used to make endoscopy-assisted myringotomy incisions in the postero-inferior quadrant (n = 5) and the antero-inferior quadrant (n = 3).

Results:

Middle-ear examination was successful in all specimens (n = 5). Access to the round window niche and adequate visualisation of the round window were achieved in all five temporal bones (100 per cent). A guide wire could be navigated to the round window niche without difficulty. Other structures identified in all specimens included the incudostapedial joint, stapedius tendon, pyramidal eminence and facial nerve via an extended myringotomy incision. The anterior middle-ear space was also successfully examined through an endoscope-guided anterior myringotomy. The opening to the eustachian tube was visualised and cannulated with a guide wire in all preparations in which this was attempted (n = 3).

Conclusions:

The 1.3 mm, interventional sialendoscope allowed adequate visualisation of the eustachian tube, middle-ear space and round window niche, with interventional capabilities, in a cadaveric model. Our result validates the feasibility of its use for trans-tympanic drug delivery.

Keywords

Temporal BoneMiddle EarEndoscopyOtologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 12 , December 2010 , pp. 1263 - 1267
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Doyle, KJ, Bauch, C, Battista, R, Beatty, C, Hughes, GB, Mason, J et al. Intratympanic steroid treatment: a review. Otol Neurotol 2004;25:1034–9CrossRefGoogle ScholarPubMed
2Alzamil, KS, Linthicum, FH Jr.Extraneous round window membranes and plugs: possible effect on intratympanic therapy. Ann Otol Rhinol Laryngol 2000;109:30–2CrossRefGoogle ScholarPubMed
3Silverstein, H, Rowan, PT, Olds, MJ, Rosenberg, SI. Inner ear perfusion and the role of round window patency. Am J Otol 1997;18:586–9Google ScholarPubMed
4Poe, DS, Rebeiz, EE, Pankratov, MM, Shapshay, SM. Transtympanic endoscopy of the middle ear. Laryngoscope 1992;102:993–6CrossRefGoogle ScholarPubMed
5Plontke, SK, Plinkert, PK, Plinkert, B, Koitschev, A, Zenner, HP, Lowenheim, H. Transtympanic endoscopy for drug delivery to the inner ear using a new microendoscope. Adv Otorhinolaryngol 2002;59:149–55Google Scholar
6Marchal, F. Sialendoscopy: the Endoscopic Approach to Salivary Gland Ductal Pathologies. Tuttlingen, Germany: Endo-Press, 2003;26Google Scholar
7Iro, H, Zenk, J, Koch, M, Bozzato, A. The Erlangen Salivary Gland Project. Part I: Sialendoscopy in Obstructive Diseases of the Major Salivary Glands. Tuttlingen, Germany: Endo-Press, 2007;42Google Scholar
8Horlbeck, DM, Matthew, NG. Middle ear endoscopy. Emedicine 2006;860570Google Scholar
9Tschabitscher, M, Klug, C. Two-port endoscopy of the middle ear: endoscopic anatomy. Arch Otolaryngol Head Neck Surg 1999;125:433–7CrossRefGoogle ScholarPubMed
10Edelstein, DR, Magnan, J, Parisier, SC, Chays, A, Isaacs, RS, Gignac, D et al. Microfiberoptic evaluation of the middle ear cavity. Am J Otol 1994;15:50–5Google ScholarPubMed
11Bomeli, SR, Schaitkin, B, Carrau, RL, Walvekar, RR. Interventional sialendoscopy for treatment of radioiodine-induced sialadenitis. Laryngoscope 2009;119:864–7CrossRefGoogle ScholarPubMed
12Nahlieli, O, Shacham, R, Shlesinger, M, Eliav, E. Juvenile recurrent parotitis: a new method of diagnosis and treatment. Pediatrics 2004;114:9–12CrossRefGoogle ScholarPubMed