Feasibility of Endoscopic Treatment of Middle Ear Myoclonus: A Cadaveric Study
Table 2
Results of temporal bone endoscopic tensor tympani transection
Temporal bone number
Previous mastoidectomy
Tensor tympani visible with 0° scope
Tensor tympani visible with 30° scope
Extended elevation of the tympanomeatal flap needed
Comments
(1) Left
Yes
Yes
Yes
No
(2) Right
Yes
Yes
Yes
No
(3) Left
Yes
Yes
Yes
No
Tensor tympani was transected bluntly with a Wullstein needle. This resulted in inadvertent incudomalleal joint instability A prominent anterior canal bulge made the scope insertion and endoscopic guided insertion of instruments somewhat challenging but the procedure was still completed with a 2.7 mm diameter scope
(4) Left
Yes
Yes
Yes
No
(5) Right
Yes
No
Yes
No
The tendon could not be seen with the 0° scope because of the narrow space between the long process of the incus and malleus handle. Better visualization was achieved with the 30° scope
(6) Right
Yes
Yes
Yes
No
(7) Right
Yes
Yes
Yes
No
(8) Left
No
Yes
Yes
No
(9) Right
No
Yes
Yes
No
(10) Left
No
No
Yes
No
The narrow ear canal required use of a 1.9 mm 30° scope rather than a 2.7 mm scope