ENDOSCOPY IN OTOLOGY AND NEUROTOLOGY

Since the early 1980s rigid endoscopes have been used by otorhinolaryn gologists in the United States primarily for sinus surgery. Recently r igid endoscopes have been used as an adjunct to standard otologic and neurotologic procedures. Diagnostic inspection of the middle ear can b e performed through a myringotomy incision to rule out perilymphatic f istula, for identification of cholesteatoma, or for evaluation of the status of the ossicular chain. During chronic ear surgery endoscopes c an be used to locate hidden cholesteatoma in difficult to visualize ar eas such as the eustachian tube, attic, sinus tympani, and beneath an intact posterior canal wall. In acoustic neuroma surgery in which hear ing preservation is an objective endoscopes are used to inspect the la teral aspect of the internal auditory canal (IAC) for residual tumor. During vestibular neurectomy endoscopes are used to view the IAC and t o help identify the cochleovestibular cleavage plane. The applications , techniques, and limitations of rigid endoscopy in otology and neurot ology are discussed.