Ear surgery is changing and becoming less invasive. These days, if you have a ruptured eardrum, a cholesteatoma cyst, a tumor or hearing loss, a doctor can use endoscopic surgery to treat you without making a surgical cut behind your ear.

“Endoscopic surgery has been performed for years in other parts of the body, but endoscopic ear surgery is still in its early stages,” said Dr. Manuela Fina, an internationally recognized expert and the first doctor to perform endoscopic ear surgery in Minnesota.

Read on to learn more about endoscopic ear surgery, how it’s different and if it’s right for your ear problem.

What is endoscopic surgery for ears and how is it different from the traditional approach?

An endoscopy procedure uses a special tool called an endoscope – a thin tube that includes a light and a camera. During the procedure, the doctor inserts the endoscope through the patient’s ear and into the ear canal to access and view the inside of the ear.

An ear endoscope is usually used for transcanal endoscopic ear surgery (TEES), which allows doctors to perform complex operations on the tiny, delicate structures in the middle ear.

This method is less invasive than the traditional way to perform an ear surgery, which is to make an incision behind the ear. The doctor then uses a straight endoscope to see into the ear.

Benefits of middle ear endoscopic procedures

There are several advantages of using endoscopy for ear surgeries. These include:

  • No incision. Because there’s no cut behind your ear, there’s usually less pain and the healing process is shorter. Plus, you won’t have a scar.
  • Your doctor has a better view. Because the endoscope is flexible, your doctor is better able to see what’s causing your ear problems. With the traditional approach, doctors can only see what’s in a straight line because a traditional scope doesn’t bend.
  • Your doctor can treat different problems. Since the endoscope can get into all the tiny recesses of the middle ear, doctors are able to perform surgeries that aren’t possible with the traditional approach.
  • You’re able to see the problem, too. During an endoscopic ear procedure, your doctor will take high-definition pictures of your inner ear. So, your doctor can use the images to explain what they see inside your ear, the treatment they recommend or the results of the surgery.

The kinds of conditions most often treated with endoscopic ear surgery

Endoscopic ear surgery can be used to treat many different conditions and can be used to remove cholesteatoma cysts, fix bones, implant prosthetics, repair eardrums, drain cysts and more.

Hearing loss surgery

Hearing loss can happen for many different reasons, including aging, exposure to loud noises, damage to your inner ear and chronic ear infections. Different types of endoscopic ear surgery for hearing include:

Tympanoplasty surgery for the eardrum

Children and adults sometimes get holes in their eardrums, called eardrum perforations. These holes can happen because of chronic ear infections or an injury – like when you hurt yourself by using Q-Tips in your ears. These perforations can also happen if you child has surgery for ear tubes.

Eardrum perforations may heal on their own. However, if the hole has been around for more than three months and doesn’t look like it will heal on its own, your doctor may recommend tympanoplasty surgery to cover or repair the hole.

Treatment for a hardened eardrum (tympanosclerosis)

Tympanosclerosis is a condition in which your body covers your eardrum with calcium deposits. This can cause the eardrum to become thick, hard and less able to move. 

Tympanosclerosis is usually caused by chronic ear inflammation and can lead to hearing loss and scar tissue. This condition doesn’t always require treatment. But if it’s affecting your hearing, your doctor may use an endoscope to remove thickened parts of the eardrum and repair the damage.

Surgery to recreate the inner ear

Otosclerosis is an inherited condition that affects the stapes bone in your middle ear. In most people, this bone vibrates to transmit sound to the inner ear. But if you have otosclerosis, this bone is stuck in place. Since the bone can’t vibrate, sounds don’t get to the inner ear and you won’t be able to hear as well. To treat otosclerosis, the doctor will perform inner ear surgery by using an endoscope to remove and replace the stapes bone.

Cholesteatoma ear cyst treatment

Cholesteatoma is a skin-lined cyst that forms inside the eardrum. This type of ear cyst is slow growing. But as a cholesteatoma gets bigger, it can erode the bones and important structures of the ear, causing hearing loss. These ear cysts can also impact the nerves in your face, affecting the movement of your facial muscles. 

To prevent damage, cholesteatomas need to be removed before they get too large – and the only way to do that is with surgery. When treating cholesteatomas, ear endoscopy works better than the traditional approaches because it’s easier to find and remove the skin growths.

Ear tumor removal surgery

Endoscopic ear surgery can be very helpful to remove different types of cancerous and noncancerous ear tumors. Ear tumors don’t grow in a straight line. So, an angled endoscope makes it easier to find and remove tumors that can grow in the nooks of the middle ear, as well as the area around your ear.

What is the recovery time for endoscopic ear surgery?

Recovery time after an ear endoscopy depends on the type of procedure you have – but most people recover in about a week. And because you don’t have an incision, you won’t have symptoms such as swelling and bleeding. So, you will likely need fewer pain medications than if you had traditional ear surgery.

What if my doctor doesn’t recommend ear endoscopy for my procedure?

Endoscopes are used with great success in many types of ear surgery. But there may be reasons why your doctor recommends a different type of procedure. For example, your ear disease may be too extensive to be approached with solely an endoscopic technique. Or it may also be that your doctor is not trained in ear endoscopy procedures.

If you would like a second opinion on what type of surgery makes sense, our team of Ear, Nose and Throat (ENTs) doctors are here for you.

How HealthPartners has led the growth in endoscopic ear surgery

While there are significant benefits to using endoscopy for ear surgery, it can still be a challenge to find a skilled surgeon to perform your procedure.

“It’s difficult to estimate how many ENTs in the U.S. are comfortable with endoscopic ear surgery, but it’s likely less than 20%,” said Dr. Fina.

Dr. Fina is working hard to fix this. Since joining HealthPartners in 2014, she has trained numerous surgeons on ear endoscopy, including ENTs at HealthPartners and others who practice across the country. She has also published extensively on the benefits of ear endoscopy.

“It’s very exciting to be doing something where you can see such positive patient results,” said Dr. Fina.

Get expert ear care from pioneers in ear endoscopy

If you have an ear condition that needs surgery and are looking for endoscopic ear surgery in Minnesota or western Wisconsin, our specialists at HealthPartners can help you understand your surgical options and perform the surgery that’s right for you.