Release date: 2010-09-09
Recently, the ear cholesteatoma of the ear that has been plagued for more than 7 years has been successfully removed by the Department of Otolaryngology of Peking Union Medical College Hospital with a microscope combined with endoscopic surgery. The patient's hearing and facial nerve function was also preserved.
In recent years, Professor Gao Zhiqiang of the department has led the research team to carry out arduous exploration in the field of minimally invasive surgery of otolaryngology and throat, and accumulated rich experience in dealing with complex rock tip lesions. A few years ago, they were keenly aware that endoscopic minimally invasive surgical techniques, which have become increasingly mature in the chest, abdomen, and nasal surgery, will have a greater role in the ear and lateral cranial base. Compared with the ear microscope, the endoscope can more easily observe the blocked position of the line of sight, avoiding the blind spot of the surgical microscope, and allowing the surgeon to completely remove the lesion under the premise of destroying the normal structure as little as possible.
It is understood that the endoscopic lens has been paid attention to since the 1990s. The main advantage is that it has great advantages in assisting in cleaning the cholesteatoma in the hidden part around the sinus and anvil joints left by the microscope; In the process of excision of acoustic neuroma, the doctor can observe the lesions in the hidden part of the internal auditory canal from different perspectives through the endoscope, which makes the trauma of the skull smaller, effectively reducing the residual rate of the tumor and improving the tumor. The vascular nerve preservation rate, the maximum retention of hearing and the reduction of cerebellar traction; it can observe the inner ear canal, the tympanic membrane, the open mastoid cavity and the sinus sinus without the ear canal incision, and can be further observed after crossing the tympanic membrane. The tympanic chamber, part of the upper tympanic cavity and probe the ossicular chain.
However, Gao Zhiqiang believes that due to the development of related surgical instruments and equipment, the current endoscopic techniques have the following disadvantages: because of the one-handed operation, some operations requiring both hands cannot be completed; the lens is easily contaminated by blood; Angle surgical instruments, the surgeon is likely to encounter the use of angled endoscopy to see the tumor tissue, but can not use the instrument to remove. Since the above shortcomings have not been overcome, and compared with endoscopic and laparoscopic surgery, the narrow and narrow space of the ear has higher requirements for endoscopic technology, so the endoscope is currently only an auxiliary means of microsurgery, The advantages have not been fully utilized.
Source: China Medical News
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