Abstract

Although it is three decades since the first use of operative endoscopy for the exploration of old mastoid cavities, the endoscope is used infrequently in the day to day surgical management of ear disease around the world. The role of the endoscopes as defined by many prominent otologists has been so marginal that most surgeons have not feltcompelled to master newer techniques and instrumentation for its use . In contrast I started using endoscopy in ear surgery just 2 years after my postgraduate completion during practice years in Saudi Arabia. It has replaced the microscope as the instrument of choice in middle ear surgery. The endoscope offers a new perspective on cholestaetoma management as it provides more anatomical as well as functional approach and widens our understanding of its pathology. Additionally the wide view provided by the endoscope enables minimally invasive transcanal access to all areas within the tympanic cavity and facilitates the complete extirpation of disease without the need for a postauricualr approach or incision . According to my clinical experience more and more cadaveric dissections are needed to provide hands on training with endoscopic ear surgeries as the future sees scarless mastoidectomies .I think endoscopes can replace the microscopes as a tool in all ear surgeries including petrous apex.