Otologic Surgery

5th Edition - December 29, 2021
Imprint: Elsevier
Editors: Derald Brackmann, Clough Shelton, Moises A. Arriaga
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 4 2 7 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 4 2 8 - 5

With its step-by-step approach and brilliant full-color design, Otologic Surgery, 5th Edition, provides the authoritative guidance you need to hone your surgical skills and ensur… Read more

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With its step-by-step approach and brilliant full-color design, Otologic Surgery, 5th Edition, provides the authoritative guidance you need to hone your surgical skills and ensure optimal outcomes for your patients. Renowned leaders in the field, led by Drs. Derald Brackmann, Clough Shelton, Moises Arriaga, and Richard K. Gurgel , cover surgical approaches to the ear and skull base, techniques, alternate approaches, and controversial issues. Hundreds of crisp line drawings, high-quality photographs, and more than 60 procedural videos provide detailed visual guidance.

Cover image
Instructions for online access
Title page
Table of Contents
Copyright
Dedication
Contributors
Acknowledgments
Video Contents
1. Otologic Instrumentation
Operating Room
Stapes Surgery
Tympanoplasty With Mastoidectomy
Endoscopic Middle Ear Surgery
Endolymphatic Sac Surgery
Neurotologic Procedures
Middle Fossa Surgery
Conclusion
Appendix 1.1 Instruments and Equipment for Otologic Surgery
2. Canalplasty for Exostoses of the External Auditory Canal and Miscellaneous Auditory Canal Problems
Exostoses of the External Auditory Canal
Miscellaneous External Auditory Canal Conditions
3. Malignancies of the Temporal Bone: Limited and Radical Temporal Bone Resection
Introduction
Tumor Considerations
History and Physical Examination
Biopsy
Diagnostic Tests
Staging
Surgical Treatment
Reconstruction
Complications
Radiation
Chemotherapy
Rehabilitation of Lower Cranial Nerve Deficits
Conclusion
4. Congenital Malformation of the External Auditory Canal and Middle Ear
Introduction
Embryology
Classification Systems
Initial Evaluation and Patient Selection
Preoperative Evaluation and Patient Counseling (Box 4.1)
Surgical Technique (Box 4.3)
Postoperative Care
Pitfalls
Results
Complications and Their Management (see Box 4.2)
Summary
5. Surgery of Ventilation and Mucosal Disease
Terminology
Pathophysiology
Treatment And Patient Selection
Patient Counseling
Surgical Technique
Alternative Techniques
Allergy Treatment
Balloon Eustachian Tuboplasty
Updated Guidelines For The Management Of Chronic Otitis Media With Effusion7
6. Diagnosis and Management of the Patulous Eustachian Tube
Anatomy and Pathophysiology of the Patulous Eustachian Tube
Etiology and the Clinical Presentation
Diagnosis
Treatment
Conclusion
7. Office Management of Tympanic Membrane Perforation and the Draining Ear
Introduction
Chronic Suppurative Otitis Media
Acute Otitis Media With An Open Tympanic Membrane
Otorrhea Management
Office Techniques For Tympanic Membrane Perforations
Otorrhea From Cerebrospinal Fluid Fistula
8. Tympanoplasty: Outer Surface Grafting Technique
Historical Aspects
Patient Selection and Evaluation
Patient Counseling
Preoperative Preparation
Preparation in the Operating Room
Surgical Technique
Postoperative Care
Pros and Cons of Outer Surface Technique
Appendix 8.1
Appendix 8.2
9. Cartilage Tympanoplasty
Patient Selection
Surgical Technique
Postoperative Care
Problems and Pitfalls
Results
Conclusion
10. Tympanoplasty—Undersurface Graft Technique: Transcanal Approach
Rationale and Requirements
Preoperative Evaluation and Patient Selection
Graft Selection
Surgical Technique
Postoperative Care
11. Endoscopic Tympanoplasty
Rationale for Endoscopic Approach
Preoperative Evaluation and Patient Selection
Preparation in the Operating Room
Surgical Technique (Box 11.1)
Postoperative Care
Results
12. Tympanoplasty—Undersurface Graft Technique: Postauricular Approach
Historical Aspects
Preoperative Fundamental Principles
Preoperative Preparation
Basic Technical Principles
Surgical Technique
Postoperative Care
Results
Cartilage Graft Tympanoplasty
Future Research and Innovation
Summary
13. Ossicular Reconstruction
Historical Perspective
Patient Selection and Evaluation
Surgical Considerations
Prosthesis Selection
Surgical Technique
Exposure and Assessment
Cartilage Preparation
Placement of Prosthesis
Postoperative Care
Factors That Make a Difference
Summary
14. Canal Wall Reconstruction Tympanomastoidectomy
Advantages And Disadvantages Of Cwu And Cwd Techniques
Rationale For The Cwr Approach
Patient Selection
Patient Preparation
Surgical Technique
Postoperative Care
Potential Pitfalls
Hearing Results
Summary
15. Surgery of Acute Infections and Their Complications
Definition and Clinical Significance
Etiology and Pathogenesis
Host Factors
Pathogen Factors
Clinical Presentation and Diagnosis
Systemic Diagnostic Approaches
Treatment
Summary
16. Mastoidectomy: Intact Canal Wall Procedure
Definitions
Evolution of Technique
Controversy
Indications for Mastoidectomy
Indications for Exteriorized Mastoid Cavity
Preoperative Evaluation and Treatment
Preoperative Counseling
Preoperative Preparation of the Patient
Surgical Technique
Facial Nerve in Surgery of Chronic Otitis Media
Management of the Labyrinthine Fistula
Repair of Canal Wall Defects
17. Mastoidectomy: Canal Wall-Down Procedure
Definitions
Indications for Canal Wall-Down Mastoidectomy
Decision-Making
Preoperative Evaluation
Preoperative Counseling
Surgical Techniques
Bondy Modified Radical Mastoidectomy
Canal Wall-Down Mastoidectomy With Tympanoplasty
Atticotomy
Radical Mastoidectomy
Mastoid Obliteration Procedure
Reconstruction of a Radical Cavity
Revision Canal Wall-Down Surgery
Postoperative Care
Potential Pitfalls
Facial Nerve
Facial Nerve Monitoring
Outcomes
18. Tympanoplasty: Staging and Use of Plastic
Postoperative Collapse of the Tympanic Membrane
Indications For Staging
Preoperative Evaluation and Counseling
Plastic in the Middle Ear
Controversy
19. Endoscope-Assisted Tympanomastoidectomy for Cholesteatoma
Historical Context of Otoendoscopy
Advantages and Disadvantages of Endoscopic Otologic Surgery
Patient Selection
Instrumentation
Patient Preparation/Room Setup
Complications
Postoperative Care
Summary
20. Complications of Surgery for Chronic Otitis Media
Preoperative Counseling
Labyrinthine Fistula Secondary to Chronic Otitis Media
Intraoperative Management of Labyrinthine Fistulas
Iatrogenic Labyrinthine Fistula
Sensorineural Hearing Loss
Facial Nerve Injury
Facial Nerve Grafting
Ossiculoplasty Complications
Dural Injury
Vascular Injury
Summary
21. Dural Herniation and Cerebrospinal Fluid Leaks
Pathogenesis
Diagnosis
Treatment
22. Laser Stapedotomy
Preoperative Evaluation
Surgery
Special Conditions
Intraoperative Complications
Postoperative Care
Results
23. Partial Stapedectomy
History
Surgical Technique: Local Anesthesia With Intravenous Sedation, Except In Young Children
Modifications of The Cup-Piston Stapes Prosthesis
Indications For Cup-Piston Prosthesis
Postoperative Results
Discussion
Summary
24. Special Problems of Otosclerosis Surgery
Intraoperative Audiometry
Routine Stapedectomy
Intraoperative Problems
Revision Stapedectomy
Surgical Technique
Far Advanced Otosclerosis
Stapedectomy For Small Air-Bone Gaps
Stapedectomy In Children
Stapedectomy In Elderly Patients
Stapedectomy In Pilots
Stapedectomy In Patients With Chronic Otitis Media
Findings In Bilateral Stapedotomy
Stapedectomy In The Obese Patient
25. Perilymph Fistula: Otic Capsule Defects Not Seen with Imaging
Clinical Phenotype
Preoperative and Intraoperative Diagnosis of Perilymph Fistula
History of Perilymph Fistula and Outcomes
Surgical Management
Summary
26. Management of Bell’s Palsy and Ramsay Hunt Syndrome
Bell’S Palsy
Ramsay Hunt Syndrome
Facial Nerve Decompression For Bell’S Palsy
Summary
27. Traumatic Facial Paralysis
Intracranial Injury To The Facial Nerve
Intratemporal Injury To The Facial Nerve
Extratemporal Injury To The Facial Nerve
Patient Evaluation
Associated Trauma
Surgical Treatment
Postoperative Care
Pitfalls Of Surgery
Results
Complications
28. Facial Nerve Tumors
Overview
Management
Surgical Techniques
Results
Complications And Management
29. Surgery for Cochlear Implantation
Patient Selection
Medical Evaluation
Selection of Ear
Hearing Preservation in Cochlear Implantation
Surgical Technique
Complications
Revision Cochlear Implantation
Bilateral Cochlear Implantation
Combined Electrical Acoustic (Hybrid) Stimulation
Single-Sided Deafness
30. Implantable Hearing Devices
Requirements of Implantable Devices
Conventional Versus Implantable Hearing Aids
Types of MIddle Ear Implants
History of Middle Ear Implants
Specific Devices
Conclusion
31. The Bone-Anchored Cochlea Stimulator—BACS
Historical Aspects
Hearing Through Bone Conduction
Osseointegration
Patient Selection
Patient Counseling
Bone-Anchored Cochlea Stimulator Models And Audiometric Criteria
Contraindications
Implant Characteristics
Surgical Treatment
Surgical Technique
Postoperative Management
Pitfalls And Complication In Surgery And During Follow-Up
Handling Of Complications
Fitting Procedure
Baha In Children
Summary
32. Surgery of the Endolymphatic SAC
Introduction
Endolymphatic Anatomy
Endolymphatic Physiology
Endolymphatic Hydrops: Pathophysiology
Ménière Disease
Treatment of Ménière Disease
Endolymphatic SAC Surgery
Endolymphatic SAC Tumors
Endolymphatic SAC Surgery Outcomes for Ménière Disease
33. Vestibular Neurectomy
Historical Background
Preoperative Evaluation
Pertinent Neuroanatomy
Selection of Surgical Approach
Endoscopic-Assisted Vestibular Neurectomy
Postoperative Course
Efficacy
Complications
34. Transmastoid Semicircular Canal Occlusion for Benign Paroxysmal Positional Vertigo and Other Disorders
Pathophysiology
Preoperative Patient Counseling and Conservative Management
Surgical Patient Selection
Preoperative Evaluation
Surgical Technique
Results
Further Applications of Canal Occlusion Surgery
Summary
35. Transcanal Labyrinthectomy
Patient Selection
Preoperative Evaluation
Preoperative Patient Counseling and Informed Consent
Surgical Technique
Postoperative Care
Surgical Complications and Management
Histopathology of Labyrinthectomy
Results of Surgery
Special Considerations
36. Intratympanic Pharmacotherapy
Conceptual Basis of Intratympanic Therapy
Transtympanic Injection Procedure
Intratympanic Corticosteroid Therapy for Sudden Snhl
Ménière Disease Diagnostic Criteria and Reporting Guidelines
Intratympanic Corticosteroid Therapy for Ménière Disease
Aminoglycoside Toxicity
Intratympanic Gentamicin Therapy for Ménière Disease
Intratympanic Gentamicin Using Fixed Dose Protocols
Intratympanic Gentamicin Using Titration to Vestibular Effect Protocols
Intratympanic Gentamicin Using Low-Dose/on-Demand Protocols
Meta-Analysis of Efficacy of Intratympanic Gentamicin
Randomized, Placebo-Controlled Trials of Intratympanic Gentamicin
Conclusion and Future Directions
37. Superior Semicircular Canal Dehiscence Syndrome
Diagnostic Evaluation
Differential Diagnosis
Preoperative Decision-Making
Bilateral Dehiscences
Operative Technique
Postoperative Care
Long-Term Results
Summary
38. Overview of Transtemporal Skull Base Surgery
Objective
Nomenclature
Collaboration in Transtemporal Surgery
Complex Case Selection Summary
39. Operations for Vascular Compressive Syndromes
Introduction
Vascular Compressive Syndromes
Operative Technique
Conclusion
40. Drainage Procedures for Petrous Apex Lesions
Presenting Symptoms
Patient Selection
Preoperative Evaluation and Patient Counseling
Surgical Techniques
Results
Complications and Management
Conclusion
41. Surgery for Glomus Tumors and Other Lesions of the Jugular Foramen
Patient Selection
Preoperative Evaluation
Patient Counseling
Surgical Approaches
Endoscopic Techniques
Results
Complications
Radiation
Summary
42. Rehabilitation of Lower Cranial Nerve Deficits After Neurotologic Skull Base Surgery
Patient Evaluation
Lower Cranial Nerve Deficits and Rehabilitation
Summary
43. Middle Fossa Approach
Indications
Preoperative Evaluation
Patient Counseling
Surgery
Results
Summary
44. Translabyrinthine Approach
Patient Selection
Surgical Procedure
Postoperative Care
Complications
Results
Summary
Editorial Comment
45. Retrosigmoid Approach to Tumors of the Cerebellopontine Angle
Surgical Anatomy
Preoperative Evaluation And Patient Counseling
Patient Selection
Patient Preparation And Positioning
Surgical Site Preparation
Special Instruments
Surgical Technique
Dressing
Postoperative Care
Results
Complications
46. Transcochlear and Transotic Approaches to the Cerebellopontine Angle
Indications
Advantages
Drawbacks
Preoperative Evaluation
Surgical Anatomy
Surgical Technique
Postoperative Care
Complications and Management
Results
Summary
47. Endoscopic Internal Auditory Canal and Cerebellopontine Angle Surgery
Introduction and Background
Endoscopic Approaches to the Internal Auditory Canal and Cerebellopontine Angle
Complications
Conclusion
48. Extended Middle Cranial Fossa Approach
Introduction
Technique
Limitations
Advantages
Conclusion
49. Anterior and Subtemporal Approaches to the Infratemporal Fossa
Patient Selection
Preoperative Evaluation
Surgical Approaches (Boxes 49.1 and 49.2)
Postoperative Care
Pitfalls and Complications (Box 49.3)
50. Endoscopic Endonasal Approaches to the Skull Base and Paranasal Sinuses
Introduction and Background
Basic Endoscopic Endonasal Concepts
Expanded Endonasal Approaches: Anatomical Modules
Complications and Learning Curve (Box 50.3)
Reconstruction
Outcomes
Future Directions
Conclusions
51. Petrosal Approach
Combined Petrosal Variations
Preoperative Evaluation
Preoperative Preparation
Surgical Techniques
Closure
Results
Future Directions
Summary
52. Neurofibromatosis 2
Introduction
Neurofibromatosis 2 Differentiated from Neurofibromatosis 1
Clinical Characteristics of Neurofibromatosis 2
Prevalence and Incidence of Neurofibromatosis 2
Imaging Studies for Neurofibromatosis 2
Molecular Genetics of Neurofibromatosis 2
Family History of Neurofibromatosis 2
Screening for Neurofibromatosis 2
Schwannoma Tumor Types
Hearing Changes in Patients with Vestibular Schwannomas
Other Tumor Types in Neurofibromatosis 2
Treatment Options for Vestibular Schwannomas in Neurofibromatosis 2
Hearing Preservation in Neurofibromatosis 2
Observation Without Surgical Intervention for Neurofibromatosis 2
Middle Fossa Craniotomy and Internal Auditory Canal Decompression Without Tumor Removal
Retrosigmoid Craniotomy with Partial Removal
Non-Hearing Preservation for Neurofibromatosis 2
Auditory Brainstem Implant for Neurofibromatosis 2
Cochlear Implants in Neurofibromatosis 2
Stereotactic Irradiation for Neurofibromatosis 2
Drug Therapy for Neurofibromatosis 2
Management of Neurofibromatosis 2
Cranial TUMOR Detection and Staging
Neurological Examination of Neurofibromatosis 2 Patients
Spinal Tumor Detection in Neurofibromatosis 2
Neuro-Ophthalmological Examination
Summary of Testing for Neurofibromatosis 2 Patients
Genetic Testing for Neurofibromatosis 2
Summary
53. Auditory Implants for the Central Nervous System
Patient Selection
Device
Anatomical Considerations
Surgical Considerations
Implantation Technique
Postoperative Care
Postoperative Complications
Results
Summary
54. Extreme Lateral Infrajugular Transcondylar Approach for Resection of Skull Base Tumors
Surgical Procedure
Complications
Results
Discussion
55. Management of Postoperative Cerebrospinal Fluid Leak
Pressure Dressing
Lumbar Drain
Wound Exploration and Reclosure
Refractory Cerebrospinal Fluid Leaks
Summary
56. Care of the Eye in Facial Paralysis and Facial Reanimation Techniques
Preoperative Clinical Evaluation
Methods of Determining the Extent and Prognosis of Facial Nerve Paralysis
Nonsurgical Interventions
Surgical Indications
Day-of-Surgery Preoperative Evaluation
Preparation in the Operating Room for Periocular Interventions
Upper Eyelid Surgery
Eyelid Coupling Procedures
Lower Eyelid Procedures
Neuromuscular Modifications: Dynamic Reanimation
Ancillary Procedures
Conclusions
57. Hypoglossal Facial Anastomosis
Patient Selection
Surgical Technique
Nerve Growth Factors and Conduits
Newer Modifications of Hypoglossal Facial Anastomosis
Results
Summary
58. Intraoperative Neurophysiological Monitoring
Monitoring Facial Nerve
Monitoring Hearing
Conclusion
59. Stereotactic Radiosurgery of Skull Base Tumors
Patient Selection
Preoperative Counseling
Surgical Technique
Gamma Knife Surgery Outcomes
Alternative Stereotactic Radiosurgery Technologies
Alternative Applications
Summary
60. Vascular Considerations in Neurotologic Surgery
Introduction
Vascular Anatomy of the Temporal Bone and Cerebellopontine Angle
Vascular Considerations in Neurotologic Approaches
Vascular Lesions of the Petrous Temporal Bone and Cerebellopontine Angle
Vascular Tumors of the Temporal Bone and Cerebellopontine Angle
Evaluation of Pulsatile Tinnitus
Conclusion
Index

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Otologic Surgery

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Derald Brackmann

Clough Shelton

Moises A. Arriaga

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