Surgical Instruments and Preparation of the Specimen

Each type of surgery requires an adequate training period for the surgeon to familiarise with the anatomy and to develop manual skills. Ear and lateral skull base are universally considered very challenging regions for neurosurgeons, otolaryngologists and maxillofacial surgeons due to their complex anatomy and the presence of delicate vascular and nervous structures (e.g. the jugular vein, the carotid artery and the cranial nerves). The application of the endoscopic technique (endoscope-assisted or exclusive endoscopic approach) to the ear and lateral skull base has gained increasing importance worldwide in the last decades and has brought new anatomical, pathological and surgical concepts in this field. Despite significant advantages compared to the use of the microscope, endoscopic ear surgery (EES) is characterised by some specific technical and manual skills that could make the learning curve of this technique particularly long.