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.