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Contribution of the Use of a Pen-Type Endoscope to Evaluate and Treat Ears Simultaneously During Cleft Palate Surgery in Late Presented Cases

Guneren, Ethem, MD*; Ture, Nurullah, MD; Karabekmez, Furkan Erol, MD; Zahir, Khalique, MD, FACS§

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1211–1213
doi: 10.1097/SCS.0000000000005272
Clinical Studies

Background: The prevalence of secretory otitis media is very high among the nonoperated cleft palate patients.

Methods: Ninety-one cleft palate operations were performed on late presented cases in Sudan, Africa. The surgeries were performed according to the Veau–Wardill–Kilner push-back technique. A laptop connected pen-type endoscopic camera was used to evaluate the tympanic membrane and address middle ear disease in all patients simultaneously. The procedure was performed after removing wax from the external auditory canal. A small incision was made with a myringotomy knife through the layers of the tympanic membrane if any sign of fluid collection was observed, after which the middle ear effusion was evacuated and the ventilation tube was inserted.

Results: This procedure was undertaken in 182 ears; 41 ears (22.5%) were healthy, 19 ears (10.5%) had chronic perforations, 122 ears (67%) underwent myringotomy procedures, and 54 (44.2%) were treated by inserting a ventilation tube. Despite the challenging work environment, standard monitoring facilities were available and all operations were completed with no early complications.

Conclusion: The pen-type camera instead of an operating microscope was a tremendous contribution, as it was easy to handle and contributed to the good outcomes. The use of this technique is strongly recommended in surgical camps.

Level of Evidence: III

*Bezmialem Vakif University, Istanbul

Government Hospital, Kilis

Kecioren Training Hospital, Health Science University, Ankara, Turkey

§Virginia Commonwealth University, Richmond, VA.

Address correspondence and reprint requests to Ethem Guneren, MD, Fellow of EBOPRAS, Professor and Head of Plastic, Reconstructive and Aesthetic Surgery, Bezmialem Vakif University, Istanbul, Turkey; E-mail:

Received 8 October, 2018

Accepted 28 November, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.