Transmastoid endoscopic-assisted Eustachian tube packing after translabyrinthine tumor resection: A cadaveric feasibility study

Nicholas L. Deep, Peter Weisskopf

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Hypothesis: Endoscopically assisted packing of the Eustachian tube (ET) will improve visualization of the protympanic space compared with standard techniques with the microscope. Background: Postoperative cerebrospinal fluid (CSF) leakage after translabyrinthine tumor resection remains a problem. Current techniques of packing the ET are limited by inadequate visualization. The objective of this study is to demonstrate the feasibility and usefulness of transmastoid endoscopic-assisted ET packing during translabyrinthine tumor resection. Methods: Eight human cadaveric temporal bone dissections were performed on four heads to test the visualization that could be obtained of the ET orifice with an endoscope via transmastoid-facial recess approach. The incus body and incus buttress were removed, the aditus ad antrum enlarged, and tensor tympani muscle was cut. The scope was placed where the incus buttress had previously resided. The ET orifice was visualized and subsequently packed. Results: In all eight temporal bones, the endoscope was successfully able to visualize the ET orifice, with improved visualization of the orifice compared with standard techniques. Surgical technique and potential pitfalls are discussed. Conclusions: The transmastoid endoscopic approach for packing the ET improves visualization of the ET orifice. Packing under direct visualization provided greater reassurance that the material entered the true ET lumen as opposed to a false passage. The technique can be performed without any significant changes to standard surgical technique, allowing for a fast and accurate closure of the ET orifice and has application in potentially decreasing postoperative CSF leak rates.

Original languageEnglish (US)
Pages (from-to)283-289
Number of pages7
JournalOtology and Neurotology
Volume38
Issue number2
DOIs
StatePublished - Jan 1 2017

Fingerprint

Eustachian Tube
Feasibility Studies
Incus
Neoplasms
Temporal Bone
Endoscopes
Tensor Tympani
Dissection
Head

Keywords

  • Endoscope
  • Eustachian tube
  • Middle ear surgery
  • Otology
  • Translabyrinthine
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Transmastoid endoscopic-assisted Eustachian tube packing after translabyrinthine tumor resection : A cadaveric feasibility study. / Deep, Nicholas L.; Weisskopf, Peter.

In: Otology and Neurotology, Vol. 38, No. 2, 01.01.2017, p. 283-289.

Research output: Contribution to journalArticle

@article{c0abbcb1455546a6a2e1f11578d7cd13,
title = "Transmastoid endoscopic-assisted Eustachian tube packing after translabyrinthine tumor resection: A cadaveric feasibility study",
abstract = "Hypothesis: Endoscopically assisted packing of the Eustachian tube (ET) will improve visualization of the protympanic space compared with standard techniques with the microscope. Background: Postoperative cerebrospinal fluid (CSF) leakage after translabyrinthine tumor resection remains a problem. Current techniques of packing the ET are limited by inadequate visualization. The objective of this study is to demonstrate the feasibility and usefulness of transmastoid endoscopic-assisted ET packing during translabyrinthine tumor resection. Methods: Eight human cadaveric temporal bone dissections were performed on four heads to test the visualization that could be obtained of the ET orifice with an endoscope via transmastoid-facial recess approach. The incus body and incus buttress were removed, the aditus ad antrum enlarged, and tensor tympani muscle was cut. The scope was placed where the incus buttress had previously resided. The ET orifice was visualized and subsequently packed. Results: In all eight temporal bones, the endoscope was successfully able to visualize the ET orifice, with improved visualization of the orifice compared with standard techniques. Surgical technique and potential pitfalls are discussed. Conclusions: The transmastoid endoscopic approach for packing the ET improves visualization of the ET orifice. Packing under direct visualization provided greater reassurance that the material entered the true ET lumen as opposed to a false passage. The technique can be performed without any significant changes to standard surgical technique, allowing for a fast and accurate closure of the ET orifice and has application in potentially decreasing postoperative CSF leak rates.",
keywords = "Endoscope, Eustachian tube, Middle ear surgery, Otology, Translabyrinthine, Vestibular schwannoma",
author = "Deep, {Nicholas L.} and Peter Weisskopf",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/MAO.0000000000001282",
language = "English (US)",
volume = "38",
pages = "283--289",
journal = "Otology and Neurotology",
issn = "1531-7129",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Transmastoid endoscopic-assisted Eustachian tube packing after translabyrinthine tumor resection

T2 - A cadaveric feasibility study

AU - Deep, Nicholas L.

AU - Weisskopf, Peter

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Hypothesis: Endoscopically assisted packing of the Eustachian tube (ET) will improve visualization of the protympanic space compared with standard techniques with the microscope. Background: Postoperative cerebrospinal fluid (CSF) leakage after translabyrinthine tumor resection remains a problem. Current techniques of packing the ET are limited by inadequate visualization. The objective of this study is to demonstrate the feasibility and usefulness of transmastoid endoscopic-assisted ET packing during translabyrinthine tumor resection. Methods: Eight human cadaveric temporal bone dissections were performed on four heads to test the visualization that could be obtained of the ET orifice with an endoscope via transmastoid-facial recess approach. The incus body and incus buttress were removed, the aditus ad antrum enlarged, and tensor tympani muscle was cut. The scope was placed where the incus buttress had previously resided. The ET orifice was visualized and subsequently packed. Results: In all eight temporal bones, the endoscope was successfully able to visualize the ET orifice, with improved visualization of the orifice compared with standard techniques. Surgical technique and potential pitfalls are discussed. Conclusions: The transmastoid endoscopic approach for packing the ET improves visualization of the ET orifice. Packing under direct visualization provided greater reassurance that the material entered the true ET lumen as opposed to a false passage. The technique can be performed without any significant changes to standard surgical technique, allowing for a fast and accurate closure of the ET orifice and has application in potentially decreasing postoperative CSF leak rates.

AB - Hypothesis: Endoscopically assisted packing of the Eustachian tube (ET) will improve visualization of the protympanic space compared with standard techniques with the microscope. Background: Postoperative cerebrospinal fluid (CSF) leakage after translabyrinthine tumor resection remains a problem. Current techniques of packing the ET are limited by inadequate visualization. The objective of this study is to demonstrate the feasibility and usefulness of transmastoid endoscopic-assisted ET packing during translabyrinthine tumor resection. Methods: Eight human cadaveric temporal bone dissections were performed on four heads to test the visualization that could be obtained of the ET orifice with an endoscope via transmastoid-facial recess approach. The incus body and incus buttress were removed, the aditus ad antrum enlarged, and tensor tympani muscle was cut. The scope was placed where the incus buttress had previously resided. The ET orifice was visualized and subsequently packed. Results: In all eight temporal bones, the endoscope was successfully able to visualize the ET orifice, with improved visualization of the orifice compared with standard techniques. Surgical technique and potential pitfalls are discussed. Conclusions: The transmastoid endoscopic approach for packing the ET improves visualization of the ET orifice. Packing under direct visualization provided greater reassurance that the material entered the true ET lumen as opposed to a false passage. The technique can be performed without any significant changes to standard surgical technique, allowing for a fast and accurate closure of the ET orifice and has application in potentially decreasing postoperative CSF leak rates.

KW - Endoscope

KW - Eustachian tube

KW - Middle ear surgery

KW - Otology

KW - Translabyrinthine

KW - Vestibular schwannoma

UR - http://www.scopus.com/inward/record.url?scp=84994718750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994718750&partnerID=8YFLogxK

U2 - 10.1097/MAO.0000000000001282

DO - 10.1097/MAO.0000000000001282

M3 - Article

C2 - 27832008

AN - SCOPUS:84994718750

VL - 38

SP - 283

EP - 289

JO - Otology and Neurotology

JF - Otology and Neurotology

SN - 1531-7129

IS - 2

ER -