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Prolonged intra-operative thermal exposure in endoscopic ear surgery: is it really safe?

Published online by Cambridge University Press:  24 August 2020

A Das ,
S Mitra ,
P Agarwal  and
A Sengupta
A Das
Affiliation:
Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
S Mitra*
Affiliation:
Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
P Agarwal
Affiliation:
Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
A Sengupta
Affiliation:
Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
*
Author for correspondence: Dr Sandipta Mitra, Institute of Post Graduate Medical Education and Research and SSKM Hospital, 244 AJC Bose Road, Kolkata700020, India E-mail: [email protected]
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Abstract

Objective

The aim of this study was to assess change in temperature, audiometric outcomes and post-operative complications following exposure to different light sources during endoscopic ear surgery.

Method

A total of 64 patients diagnosed with chronic otitis media with central perforation and pure conductive hearing loss underwent endoscopic type 1 tympanoplasty. The patients were randomised into two groups based on the light source used: xenon or light-emitting diode. Temperature was measured using a K type thermocouple at the promontory and round window niche. Mean temperature change with respect to operating time, mean audiometric change, incidence of vomiting in the first 24 hours, vertigo and tinnitus at the end of the first week were observed.

Results

Mean temperature change showed a statistically significant difference with increasing length of operating time with the xenon light source and when the two light sources were compared for a particular time interval. Mean audiometric change showed statistically significant deterioration at higher frequencies (4, 6 and 8 kHz) with the xenon light source but only at 8 kHz for the light emitting diode source. When the mean audiometric change was compared between light sources for a particular frequency, statistical significance was found at 4, 6 and 8 kHz. Post-operative complications were vomiting, vertigo and tinnitus (p-values of 0.042, 0.099 and 0.147, respectively, between two groups).

Conclusion

Light emitting diodes are associated with less significant middle-ear temperature rises and audiometric changes at higher frequencies when compared to xenon light sources. Hence, xenon should be replaced with cooler light sources.

Keywords

Otologic Surgical ProceduresEndoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 8 , August 2020 , pp. 727 - 731
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr S Mitra takes responsibility for the integrity of the content of the paper

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