Middle-ear endoscopy and trans-tympanic drug delivery using an interventional sialendoscope: feasibility study in human cadaveric temporal bones.
OBJECTIVE
This study aimed to assess the feasibility of using a 1.3 mm, semi-rigid, interventional salivary endoscope for middle-ear endoscopy, and as a trans-tympanic route for delivery of medication, in human cadaveric temporal bones.


METHODS
Human cadaveric study.


METHODS
Five temporal bones harvested from human cadavers were examined. A 1.3 mm, interventional sialendoscope was used to make endoscopy-assisted myringotomy incisions in the postero-inferior quadrant (n = 5) and the antero-inferior quadrant (n = 3).


RESULTS
Middle-ear examination was successful in all specimens (n = 5). Access to the round window niche and adequate visualisation of the round window were achieved in all five temporal bones (100 per cent). A guide wire could be navigated to the round window niche without difficulty. Other structures identified in all specimens included the incudostapedial joint, stapedius tendon, pyramidal eminence and facial nerve via an extended myringotomy incision. The anterior middle-ear space was also successfully examined through an endoscope-guided anterior myringotomy. The opening to the eustachian tube was visualised and cannulated with a guide wire in all preparations in which this was attempted (n = 3).


CONCLUSIONS
The 1.3 mm, interventional sialendoscope allowed adequate visualisation of the eustachian tube, middle-ear space and round window niche, with interventional capabilities, in a cadaveric model. Our result validates the feasibility of its use for trans-tympanic drug delivery.
Department of Otolaryngology Head Neck Surgery, Louisiana State University, New Orleans, Louisiana 70112, USA.
G
G
Peters
J
J
Lin
M A
MA
Arriaga
D W
DW
Nuss
B
B
Schaitkin
R R
RR
Walvekar
D002102:Cadaver; D016503:Drug Delivery Systems / Q000295:instrumentation*; D004432:Ear, Middle; D019723:Endoscopes; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D013506:Otologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D018987:Salivary Ducts; D013701:Temporal Bone; D014432:Tympanic Membrane / Q000601:surgery