The application of endoscopic technology in otorhinolaryngology-head and neck surgery Tracing the history of the use of cystoscopy with illumination at the front end was first used by Nitze in Germany in 1879; Hirshman first used a modified cystoscope for endoscopic examination of the nasal cavity and sinuses in 1901; endoscopy began to be used in Europe and Japan in the 1970s; in the early 1980s, Austrian scholars founded the endoscopic sinus surgery technique; etc. The endoscopic sinus surgery technique was developed and perfected; nasal endoscopy was started in China in the early 1990s; at present, the application of endoscopy is not only limited to rhinology surgery, but its application has been extended to the whole field of otorhinolaryngology-head and neck surgery, which has promoted the further development of the whole. Endoscopy in Rhinology What is the philosophy of modern surgical techniques? Functional preservation with guaranteed efficacy, which means minimally invasive. The reasons for the rapid development of endoscopic techniques are: 1. efficacy; 2. minimally invasive. The use of nasal endoscopy has brought about fundamental changes in the diagnosis and treatment of nasal diseases. Comparison between traditional surgery and endoscopic surgery Maxillary sinusitis (sinusitis) Traditional surgery requires a gingival incision, a window in the anterior wall of the maxillary sinus (with a chisel), removal of the mucosa in the maxillary sinus, filling the maxillary sinus with gauze strips, and suturing the incision; there is a lot of intraoperative bleeding, postoperative swelling in the cheek is obvious, and there is a longer period of numbness and abnormal sensation in the operated area (cheek, upper lip) after discharge from the hospital. If the surgery is performed under local anesthesia, it is especially scary when chiseling, and it is also more painful when removing the stitches and extracting the gauze stuffing after surgery. Endoscopic surgery does not require incision and uses the natural orifice to enter the operative cavity. Since the surgery is performed under direct vision, the normal mucosa is preserved to the maximum extent on the basis of removing the lesion, so that the cilia function can be preserved and the patient’s own physiological function can be preserved to the maximum extent, and the polymer expansion sponge can be filled or not filled after the surgery according to the situation, which results in short operation time, fast recovery and no postoperative complications. Deviated nasal septum Traditional surgery is done under the frontal band mirror, and it is entirely by hand when stripping the mucosa on both sides of the nasal septum, which is easy to cause perforation of the septum, especially in the post-traumatic misaligned healed nasal septal deviation, the mucosa is not in the same plane, which causes a high chance of perforation and more bleeding. Endoscopic surgery is done under direct vision, which can achieve precise peeling of mucosa and removal of cartilage, and even if there is intraoperative perforation, it can be easily repaired in one stage. Nasal polyps Traditional surgery is performed under the frontal bandoscope, and the nasal polyp is strangled with a trap, which actually removes the exposed nasal polyp, while the root of the nasal polyp is often left in the sinus cavity, so such patients are subject to recurrence after surgery. Moreover, since the polyps are strangled with wires, there is more intraoperative bleeding. Endoscopic surgery is done under direct vision, using different angles of the endoscope can clearly open the maxillary sinus, sieve sinus, frontal sinus and butterfly sinus and completely remove the root of the polyp, using the latest cutting suction can easily do to remove the lesion and maximize the preservation of normal mucosa. Benign and malignant tumors of the nasal cavity and sinuses For some benign tumors of the nasal cavity and sinuses such as involuted papilloma, sinus cysts involving the pterygopalatine fossa and certain malignant tumors such as olfactory blastoma can be completely removed endoscopically, avoiding facial incisions and causing minimal damage. In contrast, traditional surgery not only leaves scars on the face, but also takes a long time, often requiring intraoperative blood transfusion and long postoperative recovery time, which increases the financial and psychological burden of patients. Endoscopic transnasal pituitary tumor resection; endoscopic transnasal cerebrospinal fluid nasal leak repair: the traditional intracranial method is very traumatic and has a low success rate (60%-70%). Endoscopic transnasal optic nerve canal decompression: The traditional surgical approaches include transnasal and maxillary sinus open sieve pathway, transnasal microsurgical optic nerve decompression, the success rate varies from 12% to 79%, since the mid-1980s, the domestic optic nerve decompression through the sieve pterygoid sinus, postoperative vision improvement and recovery rate is 50%-70%. The advantages are no facial scar, less tissue damage, clear intraoperative anatomical landmarks, and short operation time, which are therefore highly recommended. Endoscopic surgery has become the mainstay of these surgeries, and has great advantages over other skull base tumors such as chordoma, chondrosarcoma, craniopharyngioma, etc. Endoscopy in otology Endoscopy combined with TV display system can observe the deep external auditory canal, tympanic membrane and tympanic chamber more clearly and accurately, and can be used to take pictures, video or keep image data by computer, which is convenient for teaching and scientific research and comparison before and after treatment, and is intuitive and accurate for diagnosis of traumatic tympanic membrane perforation and auditory chain injury. Endoscopic tympanic membrane repair with less bleeding, clear vision and good surgical results is highly recommended by patients and doctors. Endoscopy in laryngology Endolaryngoscopy: laryngeal endoscopy technique is an important tool for diagnosis and treatment of deep intracavitary diseases. It includes rigid tube direct laryngoscope, fiberoptic laryngoscope, stroboscope, video laryngoscope and multimedia analysis system. They can directly observe the soft tissue damage in the larynx, the size and deformation of the laryngeal cavity, and the presence of cartilage fractures, and play an important role in the identification of the cause of vocal cord movement disorders. A fiberoptic laryngoscope uses a bundle of soft optical fibers to deliver light to the larynx while sending images to the eye or camera. The fiberoptic laryngoscope is introduced through the nasal cavity, passes through the nasopharynx, and slowly reaches along the base of the tongue and epiglottis to the laryngopharynx and vocal cords. Not only can the pharynx and larynx be observed in detail, but also the movement of the vocal cords can be observed without any discomfort. Therefore, fiberoptic laryngoscopy has many advantages: 1. The mirror body is thin and soft and can be bent, so no special position is required during the examination and the patient suffers little pain; 2. It can be performed in normal physiological state to observe breathing, swallowing and vocal function; 3. Voice therapy; 5. While undergoing the examination, patients can speak, sing, whistle, or even play a musical instrument or sit quietly and rest normally with minimal interference from the examination. Video laryngoscopy is an emerging laryngeal endoscopic technique that can be used to support laryngoscopic procedures for vocal fold polyps, vocal fold nodules, vocal fold leukoplakia, vocal fold keratosis, and early laryngeal cancer. It is characterized by minimally invasive, not only short operation time, but also delicate surgery.