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Eur Arch Otorhinolaryngol. 2018 Dec;275(12):2933-2939. doi: 10.1007/s00405-018-5153-7. Epub 2018 Oct 1.

Novel three-dimensional image system for endoscopic ear surgery.

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Department of Otolaryngology, Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.
Department of Otolaryngology, Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Audiology and Speech Language Pathology, Mackay Medical College, Taipei, Taiwan.
Department of Medical Education, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.



The objective of this study was to evaluate the clinical outcomes of conventional two-dimensional (2D) endoscope with a novel computer-based three-dimensional (3D) imaging system for otologic surgical procedures.


A conventional 2D monocular endoscope with a novel computer-based 3D imaging system was applied to 18 otologic surgical procedures, including chronic otitis media (COM), cholesteatoma, otosclerosis, external canal osteoma and cochlear implant. Operation duration and complications of COM and attic cholesteatoma were recorded to compare 2D and 3D endoscopic ear surgery. Questionnaires were completed by 35 observers participating in the procedures and were used to evaluate clinical and potential side effects.


The surgical procedures were performed smoothly for all patients. No patient required switching to conventional 2D endoscopic surgery. No significant differences were apparent in operation duration using the 3D imaging system for chronic otitis media and attic cholesteatoma compared with conventional 2D endoscopic ear surgery. Thirty-five observers completed the questionnaires. Most of them agreed that this 3D imaging system enabled them to perceive stereoscopic vision (94%), provide superior depth perception (85%). Furthermore, 97.1% reported no visual fatigue or discomfort when observing the 3D images.


Our study demonstrated that the computer-based 3D imaging system enables the application of 3D vision technology to otologic surgery. The system has no obvious side effects, such as visual fatigue or time delay. It not only facilitates performing the related surgical procedures but also helps in teaching and learning endoscopic ear surgeries.


Endoscope; Mastoidectomy; Stereoscopic vision; Three dimension (3D); Tympanoplasty

[Indexed for MEDLINE]

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