Why Recent Innovations in the ENT Endoscope Market Are Causing a Backlash

female surgeon in a hospital in blue tonesThe ear, nose, and throat (ENT) specialty, also known as otorhinolaryngology, is a medical field with over 300 million procedures conducted globally in 2022. This market is set to grow larger than its current value as innovations continue to bring more solutions to the table, to help a wider range of patients.

Each year, the field of ENT endoscopes emerges as a leading force in annual growth. Since their introduction in the mid-1800s, endoscopes have revolutionized the way doctors globally examine the human body through various openings, facilitating accurate diagnoses. The evolution of these devices has been remarkable since their inception. A pivotal advancement occurred when the illumination system transitioned from a miniature lamp embedded within the endoscope to an external light source, transmitting light through a flexible fiber optic cable within the body cavity (Hunt, 2001).

Fiber Optic Endoscopes and Video Endoscopes

The introduction of fiber optic endoscopes marked a significant transformation in the market despite their higher cost compared to the previous generation of endoscopes. Their groundbreaking light sourcing fundamentally altered and enhanced the way doctors conducted patient inspections. However, as time advanced, a new type of endoscope with a more innovative visualization system emerged.

These cutting-edge devices are known as video endoscopes, and they are increasingly dominating the ENT endoscopes market. The key distinction between fiber optic endoscopes and video endoscopes lies in how they transmit images. Fiberscopes utilize eyepieces to receive images transmitted through optical fibers, whereas videoscopes display the image directly on a screen through charge-coupled device (CCD) chips (Chamness, 2011). This technology provides superior image quality, improved flexibility, and broader angles of visualization compared to fiber optic endoscopes.

ENT video endoscopes have driven the global market through their considerably higher sales and selling price (almost double the price of a fiber scope). The main advantage of video endoscopes is their superior video quality compared to fiberscopes. New improvements have increased the image quality to even 4K. Therefore, the price of these scopes is higher than their fiber counterparts because of the innovation put into place for these scopes. On top of that, the sales of CCD and the screen make these scopes a lucrative business for any medical device company to enter.

Amid the COVID-19 pandemic, the market expedited the transition from fiberscopes to videoscopes as a result of safety considerations. The optical system of fiberscopes necessitates doctors to be in close proximity to a patient's airways during examination, heightening the risk of virus transmission. Conversely, videoscopes display the image on a screen, enabling doctors to maintain a safer distance from the patient's body openings.

The Development of Single-Use Endoscopes 

With all the innovations mentioned in the endoscopy field, there is one issue that limits the endoscopes market: the endoscopy reprocessing cost. Because ENT endoscopes are inserted inside more than one patient’s cavities, they must be sanitized through a reprocessing procedure. The procedure uses chemical agents that damage the scope while killing all the pathogens. This means that endoscopes will need servicing and parts replacement throughout their use, increasing the upkeep cost for these devices. In some cases, even after the reprocessing process is done properly, some pathogens can transmit the infection to the next patient. These infections drive up the cost for healthcare systems worldwide because patients will need additional treatments. Financial loss is not the only downside of secondary infections; sometimes, patients pay the price with their lives (Mouritsen,2020). Medical facilities also cannot discard their endoscopes after every patient because the price of some of them can reach up to thousands of dollars per scope.

In 2010, Ambu introduced the next class of ENT endoscopes into the global market. The single-use endoscopes were invented to address the issue of secondary infection and reprocessing costs. The newest disposable endoscopes offer somewhat similar image quality as video endoscopes while being financially feasible enough to be discarded after each use. Most single-use endoscopes are packed in sterilized packages, virtually decreasing the chance of infection to zero. Since their invention, this endoscope class has experienced high global sales growth; in 2022, they control a considerable share of the global ENT endoscopy market. The one major global event which increased the demand for these devices drastically was the COVID-19 pandemic. Medical facilities worldwide sought a sterility-guaranteed endoscopy solution to conduct desperately-needed procedures on high-risk patients.

While the single-use ENT endoscope sector is anticipated to experience sustained growth until 2029, it faces specific constraints. A significant hindrance to this market is the escalating entry of various companies introducing disposable endoscopes. In recent years, Verathon and Karl Storz have emerged as the sole contenders challenging Ambu's dominance in this market. The competitive landscape compels market players to reduce prices, ultimately impeding the overall growth of the market.

Recent Backlash and What the Future May Hold

Competitive pricing is not the only reason why the growth of this market is hindered. These scopes are also facing backlash from different medical societies throughout Europe. There are many ongoing “green endoscopy” campaigns in western Europe to forbid hospitals from acquiring single-use scopes out of fear of plastic pollution. The most famous of these campaigns are run by the British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG), and Centre for Sustainable Health (CSH) to minimize the environmental effect of endoscopy in general (Sebastian, et al., 2022). Besides the environmental concerns, these organizations believe the guaranteed sterility of these devices has not been fully proven. Furthermore, their performance compared to reusable scopes is also under heavy criticism.

Despite all the pushback, disposable endoscopes are thriving in markets globally. It is expected that disposable ENT endoscopes will more than double their market share by the end of 2029. There are many reasons behind this significant success, but the two major reasons are cost-effectiveness and convenience. Furthermore, the recent COVID-19 pandemic has led to an increase in demand for disposable medical devices to prevent cross-contamination and reduce the spread of the virus. Environmental policies in Europe cannot hold the global market to a halt and the transition to single-use scopes seems inevitable, especially with the ongoing advancements in technology and materials that have improved their safety and efficacy.

For further insights, please see the report by ENT Endoscope Market Size, Share, & COVID-19 Impact Analysis - Global - 2023-2029 iData Research.

About the Authors

Ali Arabnejad is a research analyst at iData Research. He develops and composes syndicated research projects regarding the medical device industry. He has published the U.S. Ear, Nose and Throat Report and is currently researching the global ENT and bronchoscopic devices report.

Kamran Zamanian, Ph.D., is CEO and founding partner of iData Research. He has spent over 20 years working in the market research industry with a dedication to the study of medical devices used in the health of patients all over the globe.

About iData Research

For 16 years, iData Research has been a strong advocate for data-driven decision-making within the global medical device, dental, and pharmaceutical industries. By providing custom research and consulting solutions, iData empowers its clients to trust the source of data and make important strategic decisions with confidence.


Chamness, C. J. (2011). Endoscopic instrumentation and documentation for flexible and rigid endoscopy. Small animal endoscopy, 3-26.

Hunt, R. H. (2001). A brief history of endoscopy. Gastroenterology121(3), 738-739.

Mouritsen, Jakob Munk, et al. "A systematic review and cost effectiveness analysis of reusable vs. single‐use flexible bronchoscopes." Anaesthesia 75.4 (2020): 529-540.

Sebastian, S., Dhar, A., Baddeley, R., Donnelly, L., Haddock, R., Arasaradnam, R., ... & Hayee, B. H. (2023). Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG) and Centre for Sustainable Health (CSH) joint consensus on practical measures for environmental sustainability in endoscopy. Gut72(1), 12-26.

Spaner, S. J., & Warnock, G. L. (1997). A brief history of endoscopy, laparoscopy, and laparoscopic surgery. Journal of Laparoendoscopic & Advanced Surgical Techniques7(6), 369-373.

Topics: Medical Devices Industry Insights