MINIATURE ENDOSCOPES IN OTORHINOLARYNGOLOGIC APPLICATIONS

Progressive miniaturization of rigid and flexible endoscopes enables t he practising otorhinolaryngologist (head and neck surgeon) to visuall y inspect regions of the upper respiratory tract that could never have been inspected directly before, or had only been accessible for direc t view by massive traumatization of the anatomic surroundings. For the otologist, microendoscopy opens up the possibility of using an endosc ope to assess the luminal situation of the Eustachian tube, in order t o detect morphological obstructions of this normally collapsed connect ion between the middle ear compartment and the nasopharynx. The first basic laser surgery on polyps and oedematous soft tissues to restore t he essential proper ventilation and drainage of the tympanic cavity ha ve been performed and data about this topic are soon to be published. The 'mother-baby endoscope' technique allows us to reach into the naso pharynx and paranasal sinuses via the natural orifices, for a direct v isual diagnosis of chronic secretory and polypous rhinosinusitis. Even small recurrences can be treated using minimally invasive techniques by fibre-delivered laser surgery in hidden areas of facial skull cavit ies. This painless technique is particularly useful in children. The d evelopment of 'sialendoscopy' i.e. microendoscopy of the salivary glan ds, is the first procedure to identify the real cause of obstructive d isorders of the major salivary glands. Direct visual inspection allows the examiner to differentiate between stenoses, secretion plugs and c alculi, In cases of sialolithiasis, laser-induced shock wave lithotrip sy (LIL) can be performed by transferring short laser pulses via an in serted fibre onto the surface of the stone to disintegrate it.