{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:02:22Z","timestamp":1773111742709,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Carl Gustav Carus Dresden an der Technischen Universit\u00e4t Dresden"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>This prospective study compared the application of a 3D exoscope (VITOM 3D) with surgical microscopes (SM) in ear surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>62 patients were included (exoscope group (E+) <jats:italic>n<\/jats:italic>\u2009=\u200931; SM group (E-) <jats:italic>n<\/jats:italic>\u2009=\u200931). Procedures included cochlea implantation (nE\u2009+\u2009=\u200910, nE- = 10), reconstructive middle ear surgery due to chronic otitis media with (COMwC; nE\u2009+\u2009=\u200911, nE- = 11) and without cholesteatoma (COMsC; nE\u2009+\u2009=\u200910, nE- = 10). Objective (e.g. set-up time and wrap-up time, corrected cut-suture-time, pure operating time, adjustment time, time per adjustment procedure, learning curves) and subjective perioperative parameters were evaluated. This paper only addressed the analysis of the objective parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The pooled data showed that the mean time delay in the E\u2009+\u2009group was significantly higher compared to the E- group with regard to set-up time and wrap-up time, corrected cut-suture time, adjustment time and time per adjustment procedure. Time delay tended to be higher for pure operating time. In all subgroups of the E\u2009+\u2009group, the objective time parameters also showed at least a tendency to be prolonged on average compared to the corresponding subgroups in the E- group. The learning curve analysis showed that the E\u2009+\u2009group (corrected cut suture time for CI surgery, mean time per adjustment procedure across all subgroups) approached the times of the E- group during the course of the study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Based on the pooled data from the study arms, the exoscope tends to be inferior to the microscope for the objective time parameters evaluated when used in ear surgery. However, due to the small group sizes, no solid conclusions could be drawn regarding the individual surgical procedures. In addition, further studies with a longer observation period are needed to minimize the influence of the learning curve on the results.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-024-09096-9","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T02:30:45Z","timestamp":1732242645000},"page":"2263-2274","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prospective study of the application of a 3D exoscope system (VITOM 3D) in ear surgery compared to conventional surgical microscopes: part I - analysis of objective parameters"],"prefix":"10.1007","volume":"282","author":[{"given":"Hai Yen","family":"Tao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Morgenstern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0431-9758","authenticated-orcid":false,"given":"Christoph","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikoloz","family":"Lasurashvili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Zahnert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Beleites","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Neudert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"9096_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1055\/s-0042-104416","volume":"96","author":"H Gudziol","year":"2016","unstructured":"Gudziol H, Gottschall R, Luther E (2016) Die Entwicklung Der Ersten OP-Mikroskope Von Zeiss Jena Und Oberkochen Bis Zur Serienfertigung. Laryngo-Rhino-Otol 96:27\u201334. https:\/\/doi.org\/10.1055\/s-0042-104416","journal-title":"Laryngo-Rhino-Otol"},{"key":"9096_CR2","first-page":"877","volume":"21","author":"A Mudry","year":"2000","unstructured":"Mudry A (2000) The history of the microscope for use in ear surgery. Am J Otol 21:877\u2013886","journal-title":"Am J Otol"},{"key":"9096_CR3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1159\/000100285","volume":"63","author":"PL Gildenberg","year":"1994","unstructured":"Gildenberg PL, Ledoux R, Cosman E, Labuz J (1994) The Exoscope - A Frame-Based Video\/Graphics System for Intraoperative Guidance of Surgical Resection. Stereotact Funct Neurosurg 63:23\u201325. https:\/\/doi.org\/10.1159\/000100285","journal-title":"Stereotact Funct Neurosurg"},{"key":"9096_CR4","doi-asserted-by":"publisher","first-page":"3639","DOI":"10.3390\/jcm11133639","volume":"11","author":"S Ferlito","year":"2022","unstructured":"Ferlito S, La Mantia I, Caruso S et al (2022) High Definition three-dimensional exoscope (VITOM 3D) in E.N.T. surgery: a systematic review of current experience. J Clin Med 11:3639. https:\/\/doi.org\/10.3390\/jcm11133639","journal-title":"J Clin Med"},{"key":"9096_CR5","doi-asserted-by":"publisher","first-page":"347","DOI":"10.2147\/OPTH.S292152","volume":"15","author":"RJ Weinstock","year":"2021","unstructured":"Weinstock RJ, Ainslie-Garcia MH, Ferko NC et al (2021) Comparative Assessment of Ergonomic Experience with Heads-Up Display and Conventional Surgical Microscope in the operating room. OPTH Volume 15:347\u2013356. https:\/\/doi.org\/10.2147\/OPTH.S292152","journal-title":"OPTH Volume"},{"key":"9096_CR6","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1097\/MAO.0000000000002095","volume":"40","author":"JC Garneau","year":"2019","unstructured":"Garneau JC, Laitman BM, Cosetti MK et al (2019) The Use of the exoscope in lateral Skull Base surgery: advantages and limitations. Otology Neurotology 40:236\u2013240. https:\/\/doi.org\/10.1097\/MAO.0000000000002095","journal-title":"Otology Neurotology"},{"key":"9096_CR7","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s00405-019-05736-7","volume":"277","author":"A Rubini","year":"2020","unstructured":"Rubini A, Di Gioia S, Marchioni D (2020) 3D exoscopic surgery of lateral skull base. Eur Arch Otorhinolaryngol 277:687\u2013694. https:\/\/doi.org\/10.1007\/s00405-019-05736-7","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9096_CR8","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1177\/0194599818816965","volume":"160","author":"S Smith","year":"2019","unstructured":"Smith S, Kozin ED, Kanumuri VV et al (2019) Initial experience with 3-Dimensional exoscope-assisted transmastoid and lateral Skull Base surgery. Otolaryngol Head Neck Surg 160:364\u2013367. https:\/\/doi.org\/10.1177\/0194599818816965","journal-title":"Otolaryngol Head Neck Surg"},{"key":"9096_CR9","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1097\/MAO.0000000000002276","volume":"40","author":"R Minoda","year":"2019","unstructured":"Minoda R, Miwa T (2019) Non-microscopic middle ear cholesteatoma surgery: a Case Report of a Novel Head-Up Approach. Otology Neurotology 40:777\u2013781. https:\/\/doi.org\/10.1097\/MAO.0000000000002276","journal-title":"Otology Neurotology"},{"key":"9096_CR10","doi-asserted-by":"publisher","first-page":"777","DOI":"10.3390\/jcm10040777","volume":"10","author":"M Wierzbicka","year":"2021","unstructured":"Wierzbicka M, Szyfter W, Greczka G, Gaw\u0119cki W (2021) Otosurgery with the high-definition three-Dimensional (3D) exoscope: advantages and disadvantages. JCM 10:777. https:\/\/doi.org\/10.3390\/jcm10040777","journal-title":"JCM"},{"key":"9096_CR11","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1017\/S002221512100044X","volume":"135","author":"M Ally","year":"2021","unstructured":"Ally M, Kullar P, Mochloulis G, Vijendren A (2021) Using a 4K three-dimensional exoscope system (vitom 3D) for mastoid surgery during the coronavirus disease 2019 pandemic. J Laryngol Otol 135:273\u2013275. https:\/\/doi.org\/10.1017\/S002221512100044X","journal-title":"J Laryngol Otol"},{"key":"9096_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06510-w","author":"G Colombo","year":"2021","unstructured":"Colombo G, Ferreli F, Di Bari M et al (2021) Introducing the high-definition 3D exoscope in ear surgery: preliminary analysis of advantages and limits compared with operative microscope. Eur Arch Otorhinolaryngol. https:\/\/doi.org\/10.1007\/s00405-020-06510-w","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9096_CR13","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1111\/coa.13902","volume":"47","author":"Y Rusetsky","year":"2022","unstructured":"Rusetsky Y, Chuchueva N, Meytel I et al (2022) Exoscopic visualisation with VITOM 3D in paediatric cochlear implantation: preliminary results. Clin Otolaryngol 47:741\u2013745. https:\/\/doi.org\/10.1111\/coa.13902","journal-title":"Clin Otolaryngol"},{"key":"9096_CR14","doi-asserted-by":"publisher","first-page":"4593","DOI":"10.1007\/s00405-021-06672-1","volume":"278","author":"U Milanesi","year":"2021","unstructured":"Milanesi U, Pasquariello B, Saibene AM et al (2021) Three-dimensional exoscope-assisted laser stapedotomy: a preliminary experience. Eur Arch Otorhinolaryngol 278:4593\u20134598. https:\/\/doi.org\/10.1007\/s00405-021-06672-1","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9096_CR15","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1002\/sim.1783","volume":"23","author":"SA Julious","year":"2004","unstructured":"Julious SA (2004) Sample sizes for clinical trials with normal data. Statist Med 23:1921\u20131986. https:\/\/doi.org\/10.1002\/sim.1783","journal-title":"Statist Med"},{"key":"9096_CR16","unstructured":"KARL STORZ SE & Co. KG (2023) Bilder VITOM 3D"},{"key":"9096_CR17","doi-asserted-by":"publisher","first-page":"S123","DOI":"10.1055\/s-0043-101812","volume":"96","author":"T Lenarz","year":"2017","unstructured":"Lenarz T (2017) Cochlear Implant\u2013 State of the art. Laryngo-Rhino-Otol 96:S123\u2013S151. https:\/\/doi.org\/10.1055\/s-0043-101812","journal-title":"Laryngo-Rhino-Otol"},{"key":"9096_CR18","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.wneu.2017.08.083","volume":"107","author":"Z Rossini","year":"2017","unstructured":"Rossini Z, Cardia A, Milani D et al (2017) VITOM 3D: preliminary experience in cranial surgery. World Neurosurg 107:663\u2013668. https:\/\/doi.org\/10.1016\/j.wneu.2017.08.083","journal-title":"World Neurosurg"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-09096-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-024-09096-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-09096-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T05:24:00Z","timestamp":1746509040000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-024-09096-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["9096"],"URL":"https:\/\/doi.org\/10.1007\/s00405-024-09096-9","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]},"assertion":[{"value":"23 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study followed the review and approval of the local ethics committee at the Technische Universit\u00e4t Dresden (BO-EK-4012022).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"was obtained from all individual participants included in the study. All procedures were performed with the understanding and written consent of each subject.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All materials and content reproduced from other sources have been appropriately credited. Permissions have been obtained for all copyrighted materials used in this manuscript and are documented in the supplementary materials.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Permission to reproduce material from other sources"}},{"value":"The authors reject competing interests in the conduct and dissemination of this research. Any potential conflicts of interest have been disclosed to the journal and are outlined in the manuscript.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}