Endoscopic Ossiculoplasty (TORP) with Prolapsed Facial Nerve

This video illustrates an endoscopic ossiculoplasty using a total ossicular replacement prosthesis (TORP) in a patient with a mixed hearing loss and a large conductive component. The video highlights the middle ear anatomy including a dehiscent and prolapsed facial nerve partially obstructing the oval window. Technical pearls for the ossiculoplasty are also highlighted.

Cameron C. Wick, MD
Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
cameron.wick@wustl.edu

J. Walter Kutz Jr., MD
Department of Otolaryngology – Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
walter.kutz@utsouthwestern.edu

Endoscopic Stapedotomy

Endoscopic ear surgery is an emerging technique championed for its improved visualization within the middle ear space. Stapes surgery presents a unique endoscopic challenge in that it offers a different type of depth perception compared to the binocular microscopic view. This video highlights the surgical steps for an endoscopic stapedotomy using a CO2 laser and Eclipse nitinol piston. The stapes footplate and stapedotomy are well visualized with the endoscope. Just like in endoscopic sinus surgery, depth perception is achieved through muscle-memory and camera movement.

Author: Cameron C. Wick, MD

Institution: Department of Otolaryngology – Head and Neck, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

Email: cameron.wick@wustl.edu

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