endoscopic procedures were performed with endoscopes (14 cm long, 3-mm diameter)
attached to a high-definition camera system and screen (Karl Storz). After
elevation of the tympanomeatal flap, the middle ear was injected with a
fluorescein solution (0.2 mg/10 mL of saline solution). Thereafter, the
epitympanum was resected with a 3-mm coarse diamond drill (Bien Air Surgery).
After suctioning of debris and fluorescein solution, the middle ear was again
injected with fluorescein. Drilling continued until the whole body of the incus
was visible.
Similarly, a microscopic epitympanectomy was performed with a surgical microscope
(Leica) via a standard retroauricular approach. The skin was retracted with hook
retractors fixed to the drapes. The simulation was completed by performing a
cortical mastoidectomy under microscopic view with standard cutting burs.