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Middle ear endoscopy and trans‐tympanic drug delivery using an interventional sialendoscope: a feasibility study in human cadaveric temporal bones
Author(s) -
Peters Geoffrey,
Lin James,
Arriaga Moises A.,
Nuss Dan W.,
Schaitkin Barry,
Walvekar Rohan R.
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21683
Subject(s) - cadaveric spasm , medicine , eustachian tube , middle ear , endoscope , temporal bone , endoscopy , cadaver , otorhinolaryngology , round window , anatomy , surgery , radiology , inner ear
The aim of our study was to assess feasibility of using a 1.3mm semi-rigid interventional salivary endoscope for middle ear endoscopy and as a route for trans-tympanic delivery of medication in human cadaveric temporal bones.Five temporal bones harvested from human cadavers were examined. A 1.3mm diameter 0 degree. Marchal interventional sialendoscope equipped with an interventional channel (0.4 mm) and an irrigation/suction channel was used. Middle ear endoscopy was performed via endoscopic guided postero-inferior and antero-superior myringotomies. The round window niche (RWN) was easily identified, and a guide wire was placed within the RWN. Also, the Eustachian tube orifice was identified and cannulated with a guide wire.Access to the RWN was obtained via a postero-inferior myringotomy in all five temporal bones (100%). A guide wire could be navigated to the RWN without difficulty in all patients. The opening to the ET was visualized and could be cannulated with a guide wire in all patients where it was attempted (N=3).The 1.3 mm interventional sialendoscope allowed adequate visualization of the ET, middle ear space, and the RWN with interventional capabilities in a cadaveric model. Our result validates the feasibility of its use for trans-tympanic drug delivery. However, the proposed indication for the use of the sialendoscope needs to be evaluated in a clinical setting. Additional cadaveric and human studies are necessary to further investigate additional applications for its use in the field of otolaryngology.