Vestibular 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.
Contributors: 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.
Use of CO2 laser in preparation for cochlear implant via round window
Contributors: 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.
Contributors: 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.
Stage 1 Microtia Repair using rib cartilage and modifications to the Nagata method of auricular formation.
This video demonstrates the use of the endoscope in cartilage myringoplasty.
Contributors: 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.
Contributors: 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.
This 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