High-definition 3D exoscope in pediatric otorhinolaryngology: a systematic literature review

This PRISMA-compliant systematic review aimed to investigate the use of and the mostcommon procedures performed with the novel 3D 4K exoscope in surgical pediatric head and necksettings. Methods: Search criteria were applied to PubMed, EMBASE and the Cochrane Reviewdatabases and included all studies published up to January 2023 reporting 3D 4K exoscope-assistedsurgeries in pediatric patients. After the removal of duplicates, selection of abstracts and full-text arti cles, and quality assessment, we reviewed eligible articles for number of patients treated, age, surgicalprocedures, and outcomes. Results: Among 54 potentially relevant records, 5 studies were consideredeligible and included in this systematic review, with reported treatment data for 182 patients. Thesurgical procedures belong to the otologic field (121 cases), head and neck surgery (25 cases) andtransoral surgery (36 cases). Exoscopy allowed high quality visualization of anatomical structuresduring cochlear implantation and during reconstruction in head and neck surgery; moreover, itimproved the surgical view of surgeons, spectators and ENT students. Conclusions: The use of 3D 4Kexoscopy has shown promising potential as a valuable tool in pediatric ORL-head and neck surgery;nevertheless, further validation of these encouraging outcomes is necessary through larger-scalestudies specifically focused on pediatric patients