Endoscopic Ear Surgery Program

Transcanal Endoscopic Ear Surgery (TEES) is a minimally invasive approach for routine and complex ear procedures. The technique utilizes the natural ear canal to access the tympanic membrane (eardrum) and beyond, with high-definition endoscopes and the latest in optic technology.

The endoscopes allow for outstanding visualization for the surgeon, which can improve diagnosis and ensure that all areas of the ear are thoroughly examined. In addition, angled endoscopes can be used to “look around corners” – enabling removal of diseased tissue while keeping healthy tissue intact.

Traditionally, ear surgery is done by making a cut behind the ear. Instead, TEES allows the surgeon to access the problem where it starts, and usually does not require an incision behind the ear. This may lead to no visible scars, shorter procedure times, less pain, and an easier recovery.

Common procedures that are done using the minimally invasive TEES approach include:

  • Tympanoplasty (repair of a hole in the eardrum)
  • Ossiculoplasty (repair or replacement of the ossicles – the small bones behind the eardrum that allow for hearing)
  • Repair of congenital abnormalities of the ossicles, including missing or malformed ossicles
  • Removal of cholesteatoma (a skin cyst that grows behind the eardrum that can be destructive, and requires surgical removal)
  • Diagnosis and reconstruction of abnormalities in the ear canal

Studies have shown that the outcomes for endoscopic ear surgery are as good or better than traditional techniques using the microscope. This includes repair of the eardrum, the ossicles, and removal of cholesteatoma. In addition, studies show that TEES techniques save the patient from an incision and stitches behind the ear and have less pain during recovery.

Conditions We Treat

  • Cholesteatoma
  • Tympanic membrane perforation (hole in the eardrum)
  • Ossicular issues/malformations
  • Conductive hearing loss
  • Congenital abnormalities of the ossicles/middle ear
  • Abnormalities and lesions in the ear canal

Our Specialists

The Endoscopic Ear Surgery Program is led by Stephen R. Hoff, MD, FACS, FAAP, a Pediatric Otolaryngologist with expertise in transcanal endoscopic ear surgery. Dr. Hoff has spoken and published widely on the topic, including the World Conferences on Endoscopic Ear Surgery in Dubai, Italy and Boston. In addition, he has been invited faculty for endoscopic ear surgery courses and seminars at Harvard, Stanford and Northwestern University, among others. He has published results on cholesteatoma excision, tympanoplasty, middle ear exploration and is currently part of International collaborations to improve outcomes for TEES. He uses TEES for the majority of ear procedures, when appropriate, and is at the forefront of new technology for endoscopic, minimally invasive techniques.

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Read Dr. Hoff’s scientific publications on transcanal endoscopic ear surgery below: 

Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma
Ghadersohi, S.; Carter, J. M.; Hoff, S. R. Laryngoscope. 2017 May 26; 127(11):2653-2658

Endoscopic middle ear exploration in pediatric patients with conductive hearing loss
Carter, J. M.; Hoff, S. R. Int J Pediatr Otorhinolaryngol. 2017 Apr 10; 96:21-24

International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Congenital Cholesteatoma
Denoyelle, F.; Simon, F.; Chang, K. W.; Chan, K. H.; Cheng, A. G.; Cheng, A. T.; Choo, D. I.; Daniel, S. J.; Farinetti, A.; Garabedian, E. N.; Greinwald, J. H.; Hoff, S. R.; Hone, S.; Licameli, G. R.; Papsin, B. C.; Poe, D. S.; Pransky, S.; Smith, R. J. H.; Triglia, J. M.; Walton, J.; Zalzal, G.; Leboulanger, N. Otol Neurotol. 2019 Dec 19; 41(3):345-351

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