For some, this article will not provide them with anything new with respect to EES – in particular, the advantages of the technique and how to achieve them. However, for those surgeons who are debating whether to embark on the ‘new’ technique, it provides a stimulating read. Of course, the proponents of the technique well illustrate the improved optics with the endoscope as compared with the microscope but also the access that it provides. The authors then proceed to describing in considerable detail, the surgical set-up that they adopt – this includes the surgical equipment, room set-up and ergonomics, giving special mention to considerations for right and left ears. They list the indications for EES which also includes inner ear and skull base. The authors also provide suggestions on how to introduce it into your practice and some pearls of wisdom to go alongside. Quite rightly they advocate trialling the technique on a course before using it on patients but this suggestion came quite late in the paper and should have been emphasised more strongly. As with all new techniques, an estimation of the average learning curve would have been useful and a further suggestion for surgeons to observe others in addition to course attendance. This was a useful beginner’s guide with helpful images and diagrams.

Basic principles of endoscopic ear surgery.
Kozin ED, Lee DJ.
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Suzanne Jervis

FRCS (ORL HNS), Shrewsbury and Telford Hospitals, NHS Trust, UK.

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