Current Status of Transcanal Endoscopic Ear Surgery (TEES) in Japan – Results Of A Questionnaire To Representatives of The Japan Otological Society In 2018

By June 7, 2019

Ito, Tsukasa1,2; Matsui, Hirooki1; Komori, Manabu; Kubota, Toshinori1; Furukawa, Takatoshi1; Uchida, Masaya1,2; Kanzaki, Sho1,2; Kobayashi, Taisuke1,2;Nishiike, Suetaka1,2; Hori, Ryusuke1,2; Matsumoto, Yu1,2; Mizutari, Kunio1,2; Minoda, Ryosei1,2; Yamauchi, Daisuke1,2; Kanemaru, Shinichi1,2; Kojima, Hiromi1,2; Kakehata, Seiji1,2
1 Japan Working Group on Endoscopic Ear Surgery (JWGEES)
2 Working Group on Endoscopic Ear Surgery of the Japan Otological Society

Introduction:
TEES is a less invasive procedure and is becoming the standard procedure for middle ear diseases. However, the indications and efficacy of TEES are controversial compared with microscopic ear surgery. We thus conducted a questionnaire on TEES in Japan.

Methods:
Study Design: A questionnaire.
Setting: The Japan Otological Society (JOS).
Subjects: Representatives of JOS
Intervention: The questionnaire was sent to 84 representatives of JOS at 57 institutions in September 2018.

Discussion:
Main Outcome Measures: The questionnaire asked about TEES adoption status; number of TEES procedures performed; indications for TEES; and attitudes toward TEES. The questionnaire results were also compared between groups that have adopted TEES and not adopted TEES.
Results: Questionnaires were returned by 62 surgeons (74%) from 45 institutions (79%). Forty surgeons (65%) have adopted TEES at 30 institutions (67%) and most of these surgeons used TEES in the treatment of chronic otitis media with perforation, middle ear anomalies, and early stage cholesteatomas. Even surgeons who have not yet to adopt TEES considered chronic otitis media, middle ear anomalies, and early stage of cholesteatomas to be indicated for TEES. Most surgeons in both groups recognized the advantages of less invasiveness, reduced cholesteatoma residual rate, intra-surgical teaching tool, but some raised concerns about safety and length of surgery.

Conclusion:
TEES has become more widely adopted in Japan. However, any surgeon who wishes to perform TEES should be required to attend educational hands-on courses to ensure that TEES is done safely, and predictable outcomes are achieved.