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

  • G Peters (a1), J Lin (a1), M A Arriaga (a1), D W Nuss (a1), B Schaitkin (a2) and R R Walvekar (a1)...

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.

Copyright

Corresponding author

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: rwalve@lsuhsc.edu

References

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1Doyle, KJ, Bauch, C, Battista, R, Beatty, C, Hughes, GB, Mason, J et al. Intratympanic steroid treatment: a review. Otol Neurotol 2004;25:1034–9
2Alzamil, KS, Linthicum, FH Jr.Extraneous round window membranes and plugs: possible effect on intratympanic therapy. Ann Otol Rhinol Laryngol 2000;109:30–2
3Silverstein, H, Rowan, PT, Olds, MJ, Rosenberg, SI. Inner ear perfusion and the role of round window patency. Am J Otol 1997;18:586–9
4Poe, DS, Rebeiz, EE, Pankratov, MM, Shapshay, SM. Transtympanic endoscopy of the middle ear. Laryngoscope 1992;102:993–6
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;59:149–55
6Marchal, F. Sialendoscopy: the Endoscopic Approach to Salivary Gland Ductal Pathologies. Tuttlingen, Germany: Endo-Press, 2003;26
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;42
8Horlbeck, DM, Matthew, NG. Middle ear endoscopy. Emedicine 2006;860570
9Tschabitscher, M, Klug, C. Two-port endoscopy of the middle ear: endoscopic anatomy. Arch Otolaryngol Head Neck Surg 1999;125:433–7
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;15:50–5
11Bomeli, SR, Schaitkin, B, Carrau, RL, Walvekar, RR. Interventional sialendoscopy for treatment of radioiodine-induced sialadenitis. Laryngoscope 2009;119:864–7
12Nahlieli, O, Shacham, R, Shlesinger, M, Eliav, E. Juvenile recurrent parotitis: a new method of diagnosis and treatment. Pediatrics 2004;114:912

Keywords

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

  • G Peters (a1), J Lin (a1), M A Arriaga (a1), D W Nuss (a1), B Schaitkin (a2) and R R Walvekar (a1)...

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