The use of the surgical assistance system "ENDOFIX exo " in endoscopic ear surgery – first results

Introduction One-handed surgery is one of the challenges of endoscopic ear surgery (EES). This can be balanced by the intraoperative usage of surgical assistance systems, which allow a two-handed approach. We present a retrospective study investigating the worldwide first application of the passive endoscope holder "Endofix exo" (Fa. AKTORmed GmbH, Barbing, Germany) in EES by means of selected quality indices.

Methods This two-arm study compared intraoperative process quality (duration of surgery, cut-suture time) and postoperative outcome quality (postoperative pain, complications, tympanic membrane closure rate, hearing results (measured across the frequencies 0.5, 1, 2, 4 kHz as PTA4), quality of life) in patients who underwent endoscopic tympanoplasty for the first time due to chronic otitis media with tympanic membrane perforation and intact ossicular chain. In Group 1 (EES-, n=30) surgery was done without holding arm (classic EES), in group 2 (EES+, n=30) surgery was performed by means of the Endofix exo.

Results Currently, 11 patients underwent classic endoscopic surgery (EES-) and 10 patients underwent surgery by means of the Endofix exo (EES+). The incision-suture time of the groups differed significantly (p<0.05). Preoperative bone conduction measurements and postoperative control measurements did not differ significantly between the groups (p>0.05). A trend toward reduction of the preoperative air-bone gap (ABG) was confirmed postoperatively after a follow-up period of 6 to 8 weeks for both groups (p>0.05). The reduction in ABG tended to be higher in the EES+ group than in the EES- group.

Conclusion  The first results show that the use of the Endofix exo offers a reasonable alternative compared to the classic EES.

Publication History

Article published online:
12 May 2023