Introduction: Three-dimensional (3D) endoscopes have been introduced to provide depth perception not previously appreciable with two-dimensional (2D) endoscopes, the current standard in Otolaryngology surgery. Improved anatomic visualization with 3D technology would theoretically result in better surgeon experience in appreciating patient-specific anatomy and improved patient outcomes. This review aims to systematically evaluate the present literature comparing the surgical safety and efficacy between 2D and 3D endoscopy in Otolaryngology procedures and as a training tool for novice Otolaryngology surgeons.
Methods: Primary studies were identified through MEDLINE, Embase and Web of Science databases. These databases were searched for all articles published prior to July 2020 that compared the outcomes of 2D and 3D endoscopy in Otolaryngology surgical procedures or in Otolaryngology-relevant simulations
Results: A total of 16 full-text articles were included in the study. In clinical trials (n=7), there was no significant difference in performance time, intraoperative, or postoperative complications with 3D endoscopy when compared to 2D endoscopy. In simulation studies (n=9), error rate, and performance time for 3D endoscopy were lower than 2D in 67% (4/6) and 33% (3/9) of studies, respectively. When participant experience was assessed, all studies reported that subjective depth perception was markedly improved with the 3D system and 3D visualization was preferred over 2D visualization. Notably, four simulation studies reported that 3D systems were found to have a subjectively shorter learning curve for appropriate surgical technique among novice surgeons.
Conclusion: Three-dimensional endoscopy showed equivalent safety and efficacy compared to 2D endoscopy in Otolaryngology surgery. Moreover, data from simulation studies suggest that 3D endoscopy could hold a meaningful role as a training tool for novice Otolaryngology surgeons.