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We found 29 results for Neurotology Otology in video
video (29)
Endoscopic Transcanal Transpromontorial Removal of an Intracochlear Schwannoma and Traditional Cochlear Implantation
videoVestibular schwannomas (acoustic neuromas) develop due to mutations in Schwann cells that cause uncontrolled cell division. As a result, a tumor forms. As these tumors grow, they can compress the cochlear nerve causing unilateral hearing loss and tinnitus. Vestibular schwannomas may cause imbalance and occasionally vertigo. Intralabyrinthine schwannomas account for about 10% of vestibular schwannomas in centers that specialize in temporal bone imaging. Intracochlear schwannomas are the most common type of intralabyrinthine schwannomas. In this video, we describe an endoscopic transcanal transpromontorial approach to intracochlear schwannoma removal. This surgery was performed by James Prueter, DO, of Southwest Ohio ENT Specialists in Dayton, OH. Video editing was performed by Austin Miller, OMS-II, Ohio University Heritage College of Osteopathic Medicine.
Middle Fossa Transventricular and Subtemporal Approach for Meningioma Resection
videoContributors: Micheala Lee This is a demonstration of using the transventricular and subtemporal corridors for resecting a large middle fossa, tentorial meningioma. The video details the microsurgical technique for detaching the tumor from the tentorial incisura, working near critical structures such as the oculomotor nerve, trochlear nerve, and posterior communiating artery. It also includes precise demonstration of how to separate the massive tumor from the feeding arterial supply stemming from the posterior cerebral artery. DOI: https://doi.org/10.17797/nbtj2jdx6l
Microvascular Decompression for Trigeminal Neuralgia (combined venous & arterial)
videoContributors: Fadi Sweiss Microvascular decompression is the most effective surgical procedure for treating trigeminal neuralgia in patients with classic symptoms. Here we present a patient who had a "duo crush" from both a vein, as well as a loop of the superior cerebellar artery. The key maneuvers to create space between the compressive element and the nerve, in order to secure the teflon "cushion," are highlighted. DOI: https://doi.org/10.17797/qgthi9k07c
Translabyrinthine Approach for Vestibular Schwannoma (Acoustic Neuroma) Resection
videoContributors: Bruce E. Mickey and J. Walter Kutz This video highlights key steps to the translabyrinthine approach for vestibular schwannoma resection. It emphases identification of the facial nerve and the benefit of facial nerve monitoring in lateral skull base surgery. DOI#: https://doi.org/10.17797/4w83z6uxam
Microtia Reconstruction: Stage 1
videoStage 1 Microtia Repair using rib cartilage and modifications to the Nagata method of auricular formation. DOI#: http://dx.doi.org/10.17797/cquv22l7p3
Bilateral Cryptotia Repair
videoContributors: Shira Koss 6 year old boy suffering from bullying at school as a result of bilateral cryptotia, a very unusual congenital ear anomaly in which the superior helix is buried under temporal skin. DOI#: http://dx.doi.org/10.17797/le4g6c5rk5
Modified Rambo Transcanal Approach for Cochlear Implantation in CHARGE Syndrome
videoContributors: Amy M. Moore, and Brandon Isaacson CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This video describes a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess.
Microtia Reconstruction Stage 2
videoThis is the second stage of Microtia Reconstruction, the first stage was depicted in a prior video. The ear is elevated and lateralized to take its 3-dimensional form, and this is accomplished with use of an anteriorly based mastoid fascial flap as well as costal cartilage graft and full thickness skin graft. Editor Recruited By: Michael Golinko, MD
Tympanoplasty with tragal cartilage graft, postauricular approach
videoTympanoplasty with tragal cartilage graft, postauricular approach Blake Hollowoa, Michael Kubala, Gresham Richter. Introduction Tympanic membrane (TM) perforations arise from multiple conditions including acute otitis media, barotrauma, chronic eustachian tube dysfunction, or as a complication of pressure equalization (PE) tube insertion. Most perforations heal spontaneously or with conservative measures such as ototopical drops and dry ear precautions. Perforations that do not heal can lead to conductive hearing loss, chronic infection, or cholesteatoma. A 6-year-old patient with a persistent TM perforation presented with otalgia and otorrhea. A tympanoplasty with a tragal cartilage graft was performed to repair the patient’s TM perforation. Methods The patient was intubated and the operation carried out under general anesthesia. Facial electrodes were inserted for facial nerve monitoring. The patient was prepped and draped in sterile fashion. The external canal was suctioned and irrigated. A tragal incision was then made to harvest a 1 cm piece of cartilage for the TM graft. The tragal incision was closed with monocryl suture. A postauricular incision was made in the natural skin crease to expose the posterior canal. Canal incisions were made to enter the external canal. A tympanomeatal flap was elevated until the middle ear was entered. The previously harvested tragal cartilage graft was inserted medial to the native TM perforation. Gel-Foam was inserted medial to the graft for support. Tragal perichondrium was inserted lateral to the tragal cartilage graft. Gel-Foam was then inserted lateral to the graft for support. The periosteum and postauricular incision were closed with vicryl suture. The external canal was inspected, then antibiotic ointment and an ear wick was inserted. The patient was dressed using a Glasscock dressing. Results The patient was discharged the same day and seen in clinic two weeks from his surgery. The incisions were healing well with no indications of infection or wound dehiscence. His pain was resolved and an appointment for formal audiology was scheduled for a 3-month follow-up visit. Conclusion Tympanoplasty with a tragal cartilage graft using a postauricular approach is a successful method to surgically correct persistent tympanic membrane perforations.
Total Facial Nerve Decompression via Combined Middle Fossa-Transmastoid Approach
videoThis video demonstrates total facial nerve decompression via combined Middle Fossa-Transmastoid approach. Gavriel D. Kohlberg, MD,1 Noga Lipschitz, MD,1 Charles B. Poff, BS,2 MD, Ravi N. Samy, MD, FACS1,3 1 Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA 2 College of Medicine, Medical University of South Carolina, Charleston, SC, USA 3 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
Middle Fossa Approach for Vestibular Schwannoma (Acoustic Neuroma) Resection
videoThis video demonstrates the operative setup and surgical steps of a middle fossa approach for the resection of vestibular schwannoma (acoustic neuroma). Authors: Cameron C. Wick, MD (cameron.wick@wustl.edu) 1 Samuel L. Barnett, MD (sam.barnett@utsouthwestern.edu) 2 J. Walter Kutz Jr., MD (walter.kutz@utsouthwestern.edu) 3 Brandon Isaacson, MD (brandon.isaacson@utsouthwestern.edu) 3 1 - Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 2 - Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX 3- Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX
Use of CO2 Flexible Fiber Laser in Lyses of Middle Ear Adhesions
videoThis video demonstrates the use of CO2 flexible fiber laser for the lyses of middle ear adhesions in a patient s/p canal wall down mastoidectomy.
Endoscopic Ossiculoplasty (TORP) with Prolapsed Facial Nerve
videoThis 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
videoEndoscopic 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
A Guide to Temporal Bone Dissection: Cortical Mastoidectomy & Facial Recess Approach (Part 1 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Description This video covers the key steps of a cortical mastoidectomy and facial recess approach during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. The first part of this video demonstrates a basic cortical mastoidectomy and focuses on fundamental principles including the preservation of the tegmen and sigmoid plate, adequate posterior canal wall thinning, continual saucerization, adequate removal of air cells, and early identification of the lateral semicircular canal and incus. The second part of the video discusses the facial recess approach and enlightens the viewer on the boundaries of the facial recess, the course of the mastoid segment of the facial nerve, and the location of the round window. Key surgical landmarks demonstrated in the course of this video include: zygomatic root, temporal line, posterior meatal wall, Henle’s spine, mastoid tip, tegmen mastoideum, sigmoid sinus, Koerner’s septum, lateral semicircular canal, incus, incus buttress, chorda tympani nerve, mastoid segment of the facial nerve, facial recess, round window niche, and round window.
A Guide to Temporal Bone Dissection: Endolymphatic Sac Dissection (Part 2 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Video Description This video shows the key steps in the dissection of the endolymphatic sac during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. This video builds on part one of our video series and demonstrates fundamentals of endolymphatic surgery including the location and appearance of the endolymphatic sac, and its relationship to the labyrinth. Key surgical landmarks demonstrated in the course of this video include: sigmoid sinus, mastoid segment of the facial nerve, retrofacial air cells, endolymphatic sac, lateral and posterior semicircular canal, and Donaldson’s line
A Guide to Temporal Bone Dissection: Lateral Temporal Bone Resection (Part 3 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Video Description This video covers the key steps of a lateral temporal bone resection during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. This video builds on part two of our video series. This approach allows for the en bloc removal of the external auditory canal and demonstrates fundamental steps of the procedure including: the propagation of a superior trough between the tegmen and the superior aspect of the external auditory canal, the extension of the facial recess inferiorly with sacrifice of the chorda tympani, and the drilling of the hypotympanic bone towards the glenoid. At the completion of the demonstration, the viewer is afforded a labelled view of the medial wall of the mesotympanum, as well as the medial aspect of the external auditory canal with an intact tympanic membrane. Key surgical landmarks demonstrated in the course of this video include: tegmen, zygomatic root, malleus, incus, stapes, glenoid, eustachian tube, mastoid segment of the facial nerve, chorda tympani nerve, facial recess, hypotympanic space, annular bone, tensor tympani tendon, cochlear promontory, pyramidal process, round window, and lateral semicircular canal.
A Guide to Temporal Bone Dissection: Labyrinthectomy (Part 4 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Video Description This video demonstrates the key steps of a labyrinthectomy during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. This video builds on part three of our video series and demonstrates fundamental steps involved in a labyrinthectomy including: the identification of the three-dimensional (3D) orientation of the semicircular canals, the location of the common crus, the relationship between the second genu of the facial nerve and the posterior semicircular canal, the relationship of the vestibule to the endolymphatic sac, the course of the subarcuate artery, and the relationship of the labyrinth to the internal auditory canal. Key surgical landmarks demonstrated in the course of this video include: posterior semicircular canal, superior semicircular canal, lateral semicircular canal, common crus, external genu of facial nerve, tympanic segment of the facial nerve, tegmen, vestibule, endolymphatic sac, endolymphatic duct, subarcuate artery.
A Guide to Temporal Bone Dissection: Internal Auditory Canal Dissection (Part 5 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Video Description This video demonstrates key steps in the dissection of the internal auditory canal during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. This video builds on part four of our video series and demonstrates fundamental steps involved in the dissection of the internal auditory canal including: establishing an inferior trough and identification of the cochlear aqueduct, establishing a superior trough and identification of the labyrinthine segment of the facial nerve, and blue-lining the internal auditory canal from porous to fundus. Key surgical landmarks demonstrated in the course of this video include: internal auditory canal, cochlear aqueduct, meatal segment of the facial nerve, labyrinthine segment of the facial nerve, 1st genu of the facial nerve, tympanic segment of the facial nerve, 2nd genu of the facial nerve, mastoid segment of the facial nerve.
A Guide to Temporal Bone Dissection: Infratemporal Approach (Part 6 of 6)
videoAuthors Mohamedkazim M. Alwani, MD1, 3 Jon L. Harper, BS1, 3 Rick F. Nelson, MD PhD1, 2, 3 Author Affiliations Department of Otolaryngology – Head and Neck Surgery1 Department of Neurological Surgery2 Indiana University School of Medicine3 Video Description This video demonstrates key steps in the infratemporal approach during lab dissection of the temporal bone. The goal of this video is to serve as a supplementary teaching resource for resident-level surgical trainees by demonstrating key surgical landmarks and proper lab dissection technique. This video builds on part five of our video series and demonstrates fundamental steps of the procedure including: decompression and mobilization of the facial nerve, dissection of the cochlear scalae, skeletonization of the carotid artery, and entry into the jugular bulb. We demonstrate the wide opening of the jugular bulb to facilitate visualization of the medial wall of the jugular bulb, which subsequently aids in the dissection of the pars nervosa. Key surgical landmarks demonstrated in the course of this video include: sigmoid sinus, jugular bulb, mastoid segment of the facial nerve, cochlear scalae, internal carotid artery, pars nervosa
Endoscopic Stapedotomy (2:55)
videoStapedotomy is used to treat conductive hearing loss caused by a fixed stapes footplate. The procedure is traditionally performed via a surgical microscope. In recent years an endoscopic approach has been increasingly utilized due to several advantages that it offers over the microscopic approach, chiefly the excellent visualization of middle ear structures provided by the endoscope. In this video we describe our technique for stapedotomy via an endoscopic approach. This surgery was performed by James Prueter, DO, of Southwest Ohio ENT Specialists in Dayton, OH. Video editing was performed by Wesley Greene, MS-4 Wright State University Boonshoft School of Medicine with assistance from Britney Scott, DO, PGY-3 Kettering Health Network Otolaryngology Surgery.
Endoscopic Tympanoplasty with Tragal Cartilage Graft in a Pediatric Patient (3:54)
videoTympanoplasty is used to repair persistent perforations of the tympanic membrane. The procedure has traditionally been performed via a surgical microscope. In recent years an endoscopic approach has been increasingly used due to several advantages that it offers over the microscopic approach, chiefly the excellent visualization of middle ear structures provided by the endoscope. In this video we describe our technique for endoscopic tympanoplasty using a tragal cartilage graft in a pediatric patient. This surgery was performed by James Prueter, DO, of Southwest Ohio ENT Specialists in Dayton, OH. Video editing was performed by Wesley Greene, MS-4 Wright State University Boonshoft School of Medicine with assistance from Britney Scott, DO, PGY-3 Kettering Health Network Otolaryngology Surgery.
Surgical management of keratosis obturans
videoKeratosis obturans is a condition of the external auditory canal (EAC) characterised by formation and accumulation of desquamated keratin resulting in varying symptoms. Clinically presents as otalgia, conductive hearing loss and recurrent infection. Typically seen in younger age group and can occur bilaterally. Extension to adjacent structures can occur and result in further complications. The proposed theory is that there is a defect in epithelial in migration resulting in widening / osteitis of external canal bone. Condition was first described by Toynbee in 1850, and named by Wreden in 1874. Pipergerdes in 1980 distinguished keratosis obturans as separate disease from external auditory canal cholesteatoma. Ever since various treatment regime has been recommended but none of them have been curative. Michael M Paparella was first to propose surgical treatment in 1966 and he then modified the surgical technique in 1981. Because the defect is in epithelial migration, canaloplasty with or without graft, without obliterating the bony canal defect will not restore epithelial migration. Hence, M. M Paparella’s surgical technique was NOT popularized. Mr Basavaraj proposes novel technique which not only clears the diseased bone but obliterates the bony defect, and grafts the ear canal to bring it back to normal shape and size to encourage normal epithelial migration.
Total Facial Nerve Decompression via Combined Middle Cranial Fossa and Transmastoid approach
videoAuthors: Gavriel D. Kohlberg, MD - University of Cincinnati Noga Lipschitz, MD - University of Cincinnati Charlie Poff, BS - Medical University of South Carolina Ravi N. Samy, MD, FACS - University of Cincinnati
Endoscopic Repair of a Jugular Diverticulum
videoWe present a case of a patient with a jugular diverticulum causing persistent pulsatile tinnitus which was successfully treated with a CO2 laser endoscopic procedure. To our knowledge this is the first instance of a dehiscent jugular diverticulum being successfully treated in this manner. We believe this procedure is advantageous when compared to other treatment modalities because it is 1) minimally invasive 2) there is decreased pain and recovery time compared to other surgical approaches and 3) the risk of serious post-op infection such as meningitis is theoretically much lower when compared to posterior auricular approaches that must expose the dura of the brain to reach the jugular diverticulum.
Transotic Approach for Cochlear Schwannoma
videoThis video shows a transotic approach for a cochlear schwannoma in a 59-year-old female who presented with sudden sensorineural hearing loss in her left three years prior. She was found to have subsequent growth of her tumor on imaging and elected to undergo surgery. The transotic approach is a valuable approach within the armamentarium of a skull base team and differs from the transcochlear approach in the handling of the facial nerve. Techniques for ear canal overclosure, eustachian tube packing and mastoid obliteration are also highlighted.
Use of CO2 laser in preparation for cochlear implant via round window
videoUse of CO2 laser in preparation for cochlear implant via round window
ENDOSCOPIC CARTILAGE MYRINGOPLASTY
videoThis video demonstrates the use of the endoscope in cartilage myringoplasty. DOI# http://dx.doi.org/10.17797/gz02921q1s
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