title: Middle ear endoscopy and trans-tympanic drug delivery using an interventional sialendoscope: a feasibility study in human cadaveric temporal bones.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology Head Neck Surgery, LSU Health Sciences Center, New Orleans, LA, USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Peters
authors.forename: James
authors.initials: J
authors.lastname: Lin
authors.forename: Moises A
authors.initials: MA
authors.lastname: Arriaga
authors.forename: Dan W
authors.initials: DW
authors.lastname: Nuss
authors.forename: Barry
authors.initials: B
authors.lastname: Schaitkin
authors.forename: Rohan R
authors.initials: RR
authors.lastname: Walvekar
mesh_terms: D000287:Administration, Topical; D002102:Cadaver; D004333:Drug Administration Routes; D016503:Drug Delivery Systems / Q000295:instrumentation*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D013701:Temporal Bone; D014432:Tympanic Membrane / Q000187:drug effects*