Background: A rigid endoscope with adjustable angle of vision for endonasal surgery has been developed by the company Acclarent. We describe the experience of one skull base surgical team using this endoscope.
Methods: We describe a case series of patients operated on using the multi-angle endoscope. Finger-tip controls allow variation of angle of view, from 10 to 100 degrees, and direction of view through a full 360 degrees.
Results: The multi-angled endoscope has been used for more than 20 cases in our institution, from routine endoscopic sinus surgery to complex skull base surgery, including transantral repair of oro-antral fistula, transsphenoidal hypophysectomy, and resections of skull base tumors. In both routine and complex cases such as hypophysectomies and tumor resections, the endoscope was able to demonstrate residual disease in areas difficult to assess with standard endoscopes. Use of the endoscope required a short learning curve. It has a slightly inferior image quality to our standard Storz endoscopes, and it lacks compatibility with current endoscope self-irrigation systems that keep the lens clear.
Conclusion: The use of a multi-angled endoscope allows the endoscopist to vary their angle of vision without needing to change endoscopes. The ability of the endoscope to identify pathology in difficult-to-assess areas may have an impact on recurrence rates for conditions such as pituitary adenomas or inverted papillomas.
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We have found the Acclarent multi-angled endoscope to be advantageous in both routine and advanced sinonasal endoscopy, particularly in its ability to rapidly assess difficult-to-see anatomical regions.
They are used in the majority of surgical endoscopic applications and enable endoscopists to visualize the surface of organs, their vessels, or pathological changes without large incisions of the body and delivering a view even more clear than with the naked eye. The main design criteria are the viewing angle, depth-of-field, magnification, image brightness, image quality, distortion, and image size, which have to be appropriately balanced.
Rigid endoscopes are commonly used in minimally invasive surgical procedures like rhinoscopy (nose), cystoscopy (urinary bladder), and laparoscopy (abdomen).
Rigid endoscopes are made of metal tubes which contain the lenses, and the light channel(s) and are available in a large range of external diameters, from 1 to 12 mm.
Commonly, rigid endoscopes have a series of high-resolution optical glass rod lenses. The endoscopes can be forward viewing (0 degrees) or angled (10&#;120 degrees) to allow visualization out of the axis of the telescope.
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