Search

Endoscopic infrared diaphanoscopy is a method of improving orientation in the nasal cavity during endoscopy-controlled endonasal surgery. The transillumination is expected to facilitate the localisation of the natural passageways between the paranasal sinuses and the nasal cavity during endoscopic procedures. The present study specifies the necessary conditions on the basis of in vitro examinations using an animal model (sheep) and an anatomical preparation of half of the human head. The questions as to what paranasal sinus is at all accessible to diaphanoscopy, whether the method actually enables the connecting pathways between an individual sinus and the nasal cavity to be identified, and what technical demands need to be met, are considered and answered.

The diagnosis of obstructive salivary duct disorders to date has been based on imaging by roentgenography and ultrasound, which do not always yield a precise diagnosis. Sialendoscopy is a new procedure for identifying the cause of obstructive symptoms with direct inspection of the efferent salivary duct system by means of a microendoscope. This new technique does not impose a strain on the patient and is performed under local anaesthesia on an outpatient basis.

The amount of different clinically available lasers is increasing. The ENT surgeon can therefore use the best laser for the planned operation. As the resources of the hospital do not increase with the laser technology, a decision has to be made whether in addition to the universal CO2-laser other types must be acquired and which type is best. This paper presents the characteristics and typical tissue interactions of several lasers for the area of the soft palate. Typical operative examples are shown, e.g. partial resection of the soft palate in patients with bronchopathy and sleep apnoea syndrome, tonsillectomy, tonsillotomy and adenotomy in adults.

Progressive miniaturization of flexible fibreoptic systems has made it possible for the first time to perform atraumatic endoscopy of the Eustachian tube and tympanic cavity with the ear drum intact. With the aid of special actively steerable microcatheters, flexible fibrescopes having outer diameters of 350 to 650 microns are inserted into the opening of the naso-pharyngeal tube and advanced into the tympanic cavity under direct visual control. This new technique is indicated for any disturbance of sound conduction and in those sensorineural hearing disorders in which direct inspection of the middle ear cavity can provide information on the pathogenesis of the disturbance. In the future it may thus replace purely diagnostic tympanoscopy. In combination with fibre-delivery laser systems, this new method forms the basis of "microendoscopically controlled laser surgery" of pathological changes within this anatomical region.