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otology and skull base surgery

Shivun Khosla, Matthew Elliot, Neil Donnelly
OBJECTIVE: To illustrate our experience when managing a complex patient with potentially life-threatening bilateral otological disease facing multisensory compromise including complete loss of audiovestibular function and visual disturbance Clinical presentation: A 67 year old lady, presented with a large left vestibular schwannoma and extensive right cholesteatoma encircling the otic capsule. She underwent translabyrinthine resection of the vestibular schwannoma, resulting in profound sensorineural hearing loss, vestibular hypofunction and corneal scarring following an initial temporary facial palsy...
March 2017: Cochlear Implants International
Hidenori Anami, Shigeru Ikeda, Kotaro Nakaya, Makoto Sugiura, Takakazu Kawamata
Spontaneous cerebrospinal fluid(CSF)otorrhea is less common than CSF leakage caused by trauma, and rarely occurs in adults. We report an adult case of CSF otorrhea. A 71-year-old woman with no traumatic or otologic history was hospitalized due to bacterial meningitis. After hospitalization, CSF leakage started suddenly from the left external ear canal. A high resolution CT scan with intrathecal administration of contrast material revealed CSF leakage in the left ear canal and multiple bone erosions in both the tegmen mastoideum and the posterior fossa aspect of the petrous bone...
December 2016: No Shinkei Geka. Neurological Surgery
Golda Grinblat, Sampath Chandra Prasad, Gianluca Piras, Jingchun He, Abdelkader Taibah, Alessandra Russo, Mario Sanna
OBJECTIVE: 1) To describe the surgical technique of drill canaplasty for exostosis and osteoma and to evaluate our results. 2) To propose a new grading system for external auditory canal stenosis (EACS). 3) To review the recent literature. STUDY DESIGN: A retrospective review. SETTING: Quarternary referral center for Otology & Skull Base surgery. SUBJECTS AND METHODS: Two hundred seventeen patients (256 ears) with exostosis or osteoma were included in the study...
December 2016: Otology & Neurotology
Robert J Yawn, Harry V Wright, David O Francis, Scott Stephan, Marc L Bennett
PURPOSE: Reanimation of facial paralysis is a complex problem with multiple treatment options. One option is hypoglossal-facial nerve grafting, which can be performed in the immediate postoperative period after nerve transection, or in a delayed setting after skull base surgery when the nerve is anatomically intact but function is poor. The purpose of this study is to investigate the effect of timing of hypoglossal-facial grafting on functional outcome. MATERIALS AND METHODS: A retrospective case series from a single tertiary otologic referral center was performed identifying 60 patients with facial nerve injury following cerebellopontine angle tumor extirpation...
November 2016: American Journal of Otolaryngology
Asmi Sanghvi, Brad Bauer, Pamela C Roehm
Hemostasis is a critical component of otologic and neurotologic surgery. In these surgeries the surgical field is small; thus, even a small amount of bleeding can obstruct the view of critical and extremely small structures. Additionally, relatively large vascular structures traverse the area; if they are encroached on by trauma or disease, bleeding must be controlled within a very small space in a meticulous fashion that does not encroach on structures of the middle ear and mastoid. The authors discuss several hemostatic agents in the middle ear, mastoid, and lateral skull base, highlighting their origins, mechanisms, advantages, and complications...
June 2016: Otolaryngologic Clinics of North America
Shawn M Stevens, Brendan P O'Connell, Ted A Meyer
PURPOSE OF REVIEW: This article aims to review relevant implications of obesity and associated comorbid conditions for the otology and neurotology surgical subspecialties. RECENT FINDINGS: Both the incidence and prevalence of obesity are rising worldwide. This condition, along with its many associated comorbidities, can adversely affect the perioperative management of patients undergoing otologic and neurotologic procedures. Preoperative assessment of the cardiopulmonary system and airway are imperative as compromise of either may lead to death...
October 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
Renuka K Reddy, Rohit K Reddy, Robert W Jyung, Jean Anderson Eloy, James K Liu
A century ago an ambitious young anatomist in Rome, Primo Dorello, who sought to understand the cause of abducent nerve palsy that often occurred in patients with severe middle ear infections, conducted intricate studies on the intracranial course of the nerve. In his findings, he identified that the abducent nerve passes through a narrow sinus near the apex of the petrous bone, which formed an osteofibrous canal. Dorello suggested that in this enclosed region the abducent nerve may be particularly vulnerable to compression due to the vascular edema accompanying the infection...
January 2016: Journal of Neurosurgery
Vincenzo Vincenti, Jacques Magnan, Maria Silvia Saccardi, Carlo Zini
OBJECTIVE: To investigate whether the use of mesna (sodium 2-mercaptoethanesulfonate), a mucolytic agent capable of breaking disulfur bonds, reduces the frequency of residual cholesteatoma in canal wall up tympanomastoidectomy. STUDY DESIGN: Retrospective study. SETTING: Tertiary care otology and skull base centers. PATIENTS: Two hundred fourteen patients operated on by means of canal wall up tympanomastoidectomy for a middle ear cholesteatoma...
December 2014: Otology & Neurotology
Marimar Medina, Filippo Di Lella, Giuseppe Di Trapani, Sampath Chandra Prasad, Andrea Bacciu, Miguel Aristegui, Alessandra Russo, Mario Sanna
OBJECTIVE: To determine the effectiveness of cochlear implant (CI) in hearing restoration after temporal bone (TB) fractures and investigate the adequacy of auditory brainstem implant (ABI) indication for TB fractures. STUDY DESIGN: Retrospective clinical study; a systematic review of the literature in PubMed was also performed to identify all published cases of bilateral TB fractures or bilateral deafness after head trauma treated by means of CI or ABI. SETTINGS: Quaternary otology and skull base surgery referral center...
February 2014: Otology & Neurotology
Benjamin P Hull, David H Darrow, Craig S Derkay
OBJECTIVE: To evaluate the financial impact of pursuing a fellowship in otolaryngology. STUDY DESIGN: Retrospective financial analysis using American Academy of Otolaryngology-Head and Neck Surgery survey data. SUBJECTS AND METHODS: The American Academy of Otolaryngology-Head and Neck Surgery report, entitled Socioeconomic Study among Members April 2011, gives a financial profile of respondents who reported their primary area of specialization as either general otolaryngology or a specific area of subspecialization...
June 2013: Otolaryngology—Head and Neck Surgery
G Strauß, S Schaller, S Nowatschin, T Wenger, M Hofer, J Meixensberger, A Dietz, T Lüth
PROBLEM: Although robust algorithms for registration and segmentation are available, the majority of surgical approaches to the temporal bone are nowadays made without navigation assistance. Beside instrument navigation (IN), functions such as distance control (DC) and navigated control (NC) can be used. This study analyzes the application of these navigation functionalities in lateral skull base and middle ear surgery. PATIENTS AND METHODS: A total of 41 patients with an indication of temporal bone approaches were included...
December 2012: HNO
Sami Tanbouzi Husseini, Enrico Piccirillo, Abdelkader Taibah, Tamama Almutair, Giulio Sequino, Mario Sanna
OBJECTIVES: The use of radiation therapy has largely widespread and becomes in many centers the preference modality of treatment for symptomatic patients who are old, medically unfit for surgical therapy, those who refuse surgery and in some recurrent or residual growing tumors. The risk of radiotherapy failure in the treatment of vestibular schwannoma might be underestimated in the literature. The purpose of this study is to show the Gruppo Otologico experience with salvage surgery to better understand the surgical outcomes and difficulties in treating vestibular schwannoma after failed radiotherapy...
March 2013: American Journal of Otolaryngology
Xisheng Li, Tianyang Cao, Zhiqiang Gao, Guodong Feng, Peng Shen
An otological drill is a fundamental apparatus used for bone-milling in ear surgery. A common problem in bone-milling is that the drill bit slips on the bone surface. To improve the operational safety of such a surgery, this article presents a new apparatus combined with an intelligent method for identifying drill slippage. A two-axis force sensor is installed on a modified drill, and it detects the force of the bone's reaction to the drill bit. By integrating the unit reaction forces of the bone and the drill bit on the contact area, the functions of the force signals are deduced, which can reflect changes in the milling parameters...
April 2012: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Mohamed Samy Elhammady, Fred F Telischi, Jacques J Morcos
This review describes the indications and techniques for the retrosigmoid approach for vestibular schwannoma, as performed by the skull base surgery group at the University of Miami. The authors present background of the retrosigmoid approach, surgical steps, and essential "technical pearls" to address complication avoidance, resulting from their expertise with this surgery.
April 2012: Otolaryngologic Clinics of North America
Jiaxi Shi, Gero Strauss, Sebastian Heininger, Tim C Lueth
In order to prevent nerve injuries during ear-nose-throat (ENT) and skull base surgery, the method Navigated Control Functional is presented. Thereby, the power of active instruments is controlled based on position information, provided by a surgical navigation system, and nerve activity information, provided by a neurophysiologic monitoring system. Electrical stimulation is usually required for the extraction of distance information from neurophysiologic signals (e.g., Electromyography (EMG)). However, this article presents an experiment to investigate a possible relationship between EMG signals and the nerve-instrument distance without additional electrical stimulation...
2011: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Paul W Gidley, Christopher R Thompson, Dianna B Roberts, Franco DeMonte, Ehab Y Hanna
OBJECTIVES/HYPOTHESIS: To describe the population of patients with malignancy affecting the ear canal and temporal bone. STUDY DESIGN: Retrospective review. METHODS: The charts of 157 patients with temporal bone cancer were reviewed for clinical outcomes. RESULTS: Between 1999 and 2009, 157 patients underwent temporal bone surgery for cancer involving the ear canal (n = 25), external ear with ear canal involvement (n = 26), periauricular skin (n = 40), parotid gland (n = 40), temporal bone (n = 13), and lateral skull base (n = 13)...
February 2012: Laryngoscope
Kyle P Allen, Brandon Isaacson, Patricia Purcell, Joe Walter Kutz, Peter S Roland
OBJECTIVE: To determine the efficacy of lumbar drainage in managing cerebrospinal fluid (CSF) leak after lateral skull base surgery. STUDY DESIGN: Retrospective case review. SETTING: Academic tertiary referral center. PATIENTS: Patients who had a lumbar subarachnoid drain placed after a lateral skull base procedure between July 1999 and February 2010 were included. INTERVENTIONS: Patients were identified by searching medical records for lateral skull base approach Current Procedural Terminology codes...
December 2011: Otology & Neurotology
Seung-Ho Shin, Shailendra Sivalingam, Giuseppe De Donato, Maurizio Falcioni, Paolo Piazza, Mario Sanna
OBJECTIVES: To present the management and outcomes of cases of tympanojugular paraganglioma (TJP) with vertebral artery (VA) involvement, and to propose the addition of the new 'V' category to the Fisch classification. MATERIALS AND METHODS: Retrospective analysis of data from a quaternary neuro-otologic and skull base referral center. We studied 230 TJP patients to identify the cases with VA involvement and present their management, surgical findings and outcome...
2012: Audiology & Neuro-otology
Ramya Balachandran, Daniel Schurzig, J Michael Fitzpatrick, Robert F Labadie
PURPOSE: Portable CT scanners are beneficial for diagnosis in the intensive care unit, emergency room, and operating room. Portable fixed-base versus translating-base CT systems were evaluated for otologic image-guided surgical (IGS) applications based on geometric accuracy and utility for percutaneous cochlear implantation. METHODS: Five cadaveric skulls were fitted with fiducial markers and scanned using both a translating-base, 8-slice CT scanner (CereTom(®)) and a fixed-base, flat-panel, volume CT (fpVCT) scanner (Xoran xCAT(®))...
March 2012: International Journal of Computer Assisted Radiology and Surgery
Raymond C Maguire, John Gull, Michael Weaver, Robert T Sataloff
Cerebrospinal fluid (CSF) fistulae have been encountered by otolaryngologists often since the advent of modern endoscopic sinus surgery, otologic surgery, and skull base surgery. Treatment of CSF leaks may include bed rest, head-of-bed elevation, stool softeners, external spinal fluid drainage, and surgery. External CSF drainage is accomplished via a lumbar spinal drain. Placement of spinal drains is often performed by neurosurgeons and anesthetists. A few otolaryngologists have been trained in the placement and management of lumbar drains, but at most otolaryngology training institutions, education in lumbar drains is not provided...
October 2010: Ear, Nose, & Throat Journal
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