Objectives: Within the last few years, oto-endoscopes have been in use for inserting transtympanic ventilation tubes. However, in terms of published studies, only a limited number have investigated the efficacy of endoscopic myringotomy and tube placement in children. The aim of this prospective study was to evaluate the feasibility of endoscopic ventilation tube insertion in children by comparing the duration and outcomes of endoscopic versus microscopic technique. Method: The study included 39 children in total (22 boys and 17 girls) aged 2-10 years and diagnosed with chronic otitis media with effusion (COME). In Group A, ventilation tube insertion was performed using oto-endoscopy in 15 patients (29 ears). In Group B, ventilation tube insertion was performed using surgical microscopy in 24 patients (44 ears). Results: The mean operative time for the microscopic technique was significantly shorter than that of the endoscopic technique (P < 0.05). No serious perioperative complications related to the techniques used occurred. Conclusions: In children, oto-endoscopic tube placement can be performed safely, but the duration of endoscopic tube placement is not shorter than that of microscopic tube placement.
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1. Rimmer J, Giddings CE, Weir N. History of myringotomy and grommets. J Laryngol Otol. 2007;121: 911-6.
2. Marchioni D, Molteni G, Presutti L. Endoscopic anatomy of the middle ear. Indian J Otolaryngol Head Neck Surg 2011; 63: 101–13.
3. Abou-Elhamd KE. Telescopic myringotomy and tube application. J Laryngol Otol. 2000; 114: 581-3.
4. Lee FP. An alternative use of video-telescopic guidance for insertion of myringotomy tube. J Laryngol Otol. 2006; 120: e10. doi. org/10.1017/S0022215105008339
5. Martellucci S, Pagliuca G, Vincentiis M. Myringotomy and Ventilation Tube Insertion with Endoscopic or Microscopic Technique in Adults: A Pilot Study. Otolaryngology Head and Neck Surgery. 2015; 152: 927–30.
6. Nassif N, Redaelli De Zinis LO, Berlucchi M, Zanetti D. Endoscopic ventilation tube placement in the pediatric age. Clin Otolaryngol. 2014; 39: 50-3.
7. Kim BD, Hsu WK, De Oliveira GS Jr, Saha S, Kim JY. Operative duration as an independent risk factor for postoperative complications in single-level lumbar fusion: an analysis of 4588 surgical cases. Spine (Phila Pa 1976). 2014; 39: 510-20. References
8. Proctor LD , Davenport DL , Bernard AC , Zwischenberger JB. General surgical operative duration is associated with increased risk-adjusted infectious complication rates and length of hospital stay. J Am Coll Surg. 2010; 210: 60 – 5.
9. Brambrink AM , Orfanakis A , Kirsch JR . Anesthetic neurotoxicity. Anesthesiol Clin. 2012; 30: 207 – 28.
10. Thiagarajan B, Ulaganathan V. Endoscope Assisted Myringoplasty. Otolaryngology online journal. 2012; 2 (1). www. jorl.net
11. Bhattarai H. Endoscopy in Otology – In Retrospect and Prospects. Nepalese Journal of ENT Head and Neck Surgery. 2012; 3: 21-3.
12. Bakshi SS. Letter to the Editor on myringotomy and Ventilation Tube Insertion with Endoscopic or Microscopic Technique in Adults: A Pilot Study. Otolaryngol Head Neck Surg. 2015; 153: 1076.
13. Abou-Elhamd K.E. Telescopic myringotomy and tube application. J. Laryngol. Otol. 2000; 114: 581–3.
14. Pollak N. Endoscopic and minimally-invasive ear surgery: A path to better outcomes. World J. Otorhinolaryngol Head and Neck Surg. 2017;3:129-35.
15. Tarabichi M. Endoscopic middle ear surgery. Ann. Otol. Rhinol. Laryngol. 1999; 108: 39–46.