1. Introduction
The development of three-dimensional (3D) endoscopy and its exoscopic application opened up new avenues for the surgery of anatomic microstructures1. An exoscopic camera has a longer focal distance than a microscope, which allows surgeons to assume a more ergonomic position during surgery. 3D and 2D monitors also provide a better view of the surgical site to assistants and residents.
3D exoscopy has already been applied in otorhinolaryngology with positive outcomes. Ahmad et al. presented the largest case series of free flap dissection and microvascular anastomosis performed under 3D vision2. Authors reported both superior lighting and better ergonomics provided by a 3D exoscope compared to a conventional microscope. Several groups of authors reported positive impressions of 3D-assisted lateral skull base surgeries3,4.
Cochlear implantation is a promising area for application of 3D visual control. Firstly, this intervention has a clear sequence of mandatory surgical steps, and, secondly, it requires high magnification and efficient spatial orientation in the deep regions of the middle ear. The goal of this study was to assess the performance of the VITOMĀ® 3D exoscopic system during cochlear implantation and to refine the technique if necessary.