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Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages

Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis medi...

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Autores principales: Wierzbicka, Małgorzata, Szyfter, Witold, Greczka, Grażyna, Gawęcki, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919662/
https://www.ncbi.nlm.nih.gov/pubmed/33669166
http://dx.doi.org/10.3390/jcm10040777
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author Wierzbicka, Małgorzata
Szyfter, Witold
Greczka, Grażyna
Gawęcki, Wojciech
author_facet Wierzbicka, Małgorzata
Szyfter, Witold
Greczka, Grażyna
Gawęcki, Wojciech
author_sort Wierzbicka, Małgorzata
collection PubMed
description Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis media (n = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope—VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope. Results: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope. Conclusions: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases.
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spelling pubmed-79196622021-03-02 Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages Wierzbicka, Małgorzata Szyfter, Witold Greczka, Grażyna Gawęcki, Wojciech J Clin Med Article Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis media (n = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope—VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope. Results: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope. Conclusions: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases. MDPI 2021-02-16 /pmc/articles/PMC7919662/ /pubmed/33669166 http://dx.doi.org/10.3390/jcm10040777 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wierzbicka, Małgorzata
Szyfter, Witold
Greczka, Grażyna
Gawęcki, Wojciech
Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title_full Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title_fullStr Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title_full_unstemmed Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title_short Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages
title_sort otosurgery with the high-definition three-dimensional (3d) exoscope: advantages and disadvantages
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919662/
https://www.ncbi.nlm.nih.gov/pubmed/33669166
http://dx.doi.org/10.3390/jcm10040777
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