Review of Transcanal Endoscopic Ear Surgery (TEES) and Bioengineering for Pediatric Otologic Surgery

Purpose of Review To review advances in TEES and bioengineering for pediatric otologic surgery and reconstruction. Recent Findings TEES has been utilized in surgeries such as cholesteatoma removal, tympanic membrane perforation repairs (i.e., myringoplasty and tympanoplasty), ossicular chain reconstruction, and stapes surgeries. TEES has been shown to be non-inferior to traditional microscopic ear surgery in terms of safety, efficacy, and surgical efficiency. Furthermore, TEES does not increase rates of complications. Although few studies specifically examine pediatric samples, the data suggest TEES also is safe and efficacious for pediatric otologic surgeries. Regarding biomaterials, patch papers remain a mainstay scaffolding material for tympanic membrane repairs, and gelatin sponges and acellular dermal allografts are strong alternatives. Current research focuses on optimizing combinations of scaffolding materials and bioactive substances. For ossicular chain reconstruction, Plastipore (R), hydroxyapatite, and titanium prosthetics are efficacious and commonly used. Summary Transcanal endoscopic ear surgery (TEES) has become widely used for evaluating and treating middle ear disease. In the past decade, a significant amount of research has been conducted supporting the utility and safety profiles of TEES for otologic surgeries. Biomaterials research has also significantly improved, but more research comparing biomaterial options is needed. Furthermore, additional investigation into the pediatric-specific population is needed.