ENDOSCOPIC TYPMPANOMASTOID EXPLORATION [FUNCTIONAL ENDOSCOPIC EAR SURGERY-FEES]

Tympano mastoidectomy is usually performed using operating microscope. This study reports a case series of tympanomastoidectomy which was performed using an endoscope. Endoscopic Tympanomastoidectomy for atticoantral type of CSOM is an excellent technique for complete removal of cholesteatoma especially from inaccessible areas of middle ear cleft including facial recess, sinustympani Transmeatal removal of disease from mastoid antrum and even tip cells is possible with endoscopes. Preservation of as much of normal mucosa of the middle ear cleft is possible with this technique, which promotes early reaeration of the mastoid cavity leading to better hearing outcome. Soft wall reconstruction has distinctive advantage of short additional time for reconstruction procedures, restoration of self cleaning EAC, early post operative epithelisation of tympanic membrane and the EAC. Limitation of endoscopic technique: The endoscopic technique of tympanomastoidectomy with softwall reconstruction is not possible in cases with large mastoid cavity and in ears where a thin lateral rim of bony meatal wall (that can support soft wall) is retained, because of extensive disease. Like Functional Endoscopic sinus surgery (FESS) for nose, Endoscopes have changed the treatment concept of atticoantral disease, with complete removal of the disease and preservation of normal mucosa, that restores the normal physiology of middle ear cleft. This has led to the development of new concept of Functional Endoscopic Ear Surgery (FEES) for atticoantral type of CSOM.