Microendoscopy of the Eustachian tube and the middle ear. Indications and clinical application

Progressive miniaturization of flexible fibreoptic systems has made it possible for the first time to perform atraumatic endoscopy of the Eustachian tube and tympanic cavity with the ear drum intact. With the aid of special actively steerable microcatheters, flexible fibrescopes having outer diameters of 350 to 650 microns are inserted into the opening of the naso-pharyngeal tube and advanced into the tympanic cavity under direct visual control. This new technique is indicated for any disturbance of sound conduction and in those sensorineural hearing disorders in which direct inspection of the middle ear cavity can provide information on the pathogenesis of the disturbance. In the future it may thus replace purely diagnostic tympanoscopy. In combination with fibre-delivery laser systems, this new method forms the basis of "microendoscopically controlled laser surgery" of pathological changes within this anatomical region.