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Endoscopic Ear and Eustachian Tube Surgery, An Issue of Otolaryngologic Clinics of North America, E-Book

Endoscopic Ear and Eustachian Tube Surgery, An Issue of Otolaryngologic Clinics of North America, E-Book

Muaaz Tarabichi | João Flávio Nogueira

(2016)

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Book Details

Abstract

This issue of Otolaryngologic Clinics of North America, devoted to Endoscopic Ear and Eustachian Tube Surgery, is guest edited by Drs. João Flávio Nogueira and Muaaz Tarabichi. Articles in this outstanding issue include: Anatomy of the Eustachian Tube; Physiology of the Eustachian Tube; Eustachian Tube Function and Testing; Radiology of the Eustachian Tube; Middle Ear and Eustachian Tube Dysfunction; Endoscopic Eustachian Tube Transnasal Surgery; Endoscopic Anatomy of the Protympanic Space; Outcomes Following Endoscopic Ear Surgery; Endoscopic Management of Superior Semicircular Canal Dehiscence; Endoscopic Management of Tumors in Middle Ear and Mastoid; Outcomes Following Endoscopic Stapes Surgery; Transtympanic Balloon Dilation of the Eustachian Tube; Selective Dysventilation Syndrome; Restoring Petrous Bone Ventilation; and Endoscopic Techniques in Tympanoplasty.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Endoscopic Ear and Eustachian Tube Surgery\r i
Copyright\r ii
CME Accreditation Page iii
PROGRAM OBJECTIVE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iii
TO ENROLL iv
METHOD OF PARTICIPATION iv
CME INQUIRIES/SPECIAL NEEDS iv
Contributors v
EDITORS v
AUTHORS v
Contents ix
Preface: Functional Endoscopic Chronic Ear Surgery: A New Horizon\r ix
Editorial: The Eustachian Tube Redefined\r ix
Anatomy of the Eustachian Tube\r ix
Endoscopic Anatomy of the Protympanum\r ix
Eustachian Tube Function\r ix
Preoperative and Intraoperative Evaluation of the Eustachian Tube in Chronic Ear Surgery\r x
The Role of Transtympanic Dilatation of the Eustachian Tube During Chronic Ear Surgery\r x
Transnasal Endoscopic Eustachian Tube Surgery\r x
Endoscopic Facial Nerve Surgery\r x
Endoscopic-Assisted Repair of Superior Canal Dehiscence\r xi
Endoscopic Management of Middle Ear and Temporal Bone Lesions\r xi
Outcomes Following Endoscopic Stapes Surgery\r xi
The Fully Endoscopic Acoustic Neuroma Surgery\r xi
Incorporating Endoscopic Ear Surgery into Your Clinical Practice\r xii
Endoscopic Techniques in Tympanoplasty\r xii
Endoscopic Management of Attic Cholesteatoma: Long-Term Results\r xii
Outcomes in Endoscopic Ear Surgery\r xii
Special Article xiii
Size as a Risk Factor for Growth in Conservatively Managed Vestibular Schwannomas: The Birmingham Experience\r xiii
OTOLARYNGOLOGIC CLINICS\rOF NORTH AMERICA\r xiv
FORTHCOMING ISSUES xiv
December 2016 xiv
February 2017 xiv
April 2017 xiv
RECENT ISSUES xiv
August 2016 xiv
June 2016 xiv
April 2016 xiv
Preface:\rFunctional Endoscopic Chronic Ear Surgery: A New Horizon xv
Editorial:\rThe Eustachian Tube Redefined xvii
Anatomy of the Eustachian Tube 1097
Key points 1097
SPATIAL ORIENTATION 1097
LENGTH 1097
COMPARTMENTS 1098
Cartilage 1098
Lumen 1098
Ligaments and Fasciae 1100
Membranous Wall 1101
Muscles 1101
Tensor veli palatini muscle 1101
Medial pterygoid muscle 1102
Levator veli palatini muscle 1104
Salpingopharyngeal muscle 1104
REFERENCES 1104
Endoscopic Anatomy of the Protympanum 1107
Key points 1107
INTRODUCTION 1107
EMBRYOLOGY 1108
BOUNDARIES 1108
Superior Boundary 1108
Inferior Boundary 1110
Anterior Boundary 1111
Medial and Posterior Boundary 1112
Lateral Boundary 1112
CONFORMATIONS 1113
NEUROLYMPHOVASCULAR SUPPLY OF THE PROTYMPANUM 1113
MORPHOFUNCTIONAL IMPORTANCE OF THE PROTYMPANUM 1115
SURGICAL IMPORTANCE OF THE PROTYMPANUM 1115
Final Common Pathway of Ventilation 1115
Cholesteatoma in the Protympanum 1115
Cerebrospinal Fluid Leak 1116
Otic Neuralgia 1116
Surgical Access to the Eustachian Tube 1117
SUPPLEMENTARY DATA 1117
REFERENCES 1117
Eustachian Tube Function 1121
Key points 1121
GENERAL INTRODUCTION 1121
TUBAL MECHANICS 1122
THE PLACE OF TUBAL PHYSIOLOGY IN PRESSURE BALANCING OF THE MIDDLE EAR CLEFT MORPHOFUNCTIONAL PARTITION 1123
Gas Exchanges 1125
Regulating Systems 1127
The in situ adaptation systems 1127
The compliance of the tympanic membrane lamina propria 1127
The fibrocartilaginous eustachian tube function 1127
The vascular system in combination with the mastoid gas cell system 1127
The peripheral and central nervous regulating systems 1129
Sensors located in the middle ear cleft 1129
Chemosensors 1129
Barosensors 1129
Sensors located at the pharyngeal orifice of the fibrocartilaginous eustachian tube 1129
Neural connection between sensors 1130
How the System Operates 1130
REFERENCES 1131
Preoperative and Intraoperative Evaluation of the Eustachian Tube in Chronic Ear Surgery 1135
Key points 1135
INTRODUCTION 1135
Valsalva Computed Tomography 1136
Case discussion 1136
COMPUTED TOMOGRAPHY ASSESSMENT OF SEGMENTAL VENTILATION FAILURES 1137
MEASURING THE OPENING PRESSURE OF THE EUSTACHIAN TUBE PREOPERATIVELY 1141
VISUAL INTRAOPERATIVE INSPECTION OF THE PROTYMPANIC SPACE 1143
Case Discussion 1143
MANAGEMENT ALGORITHM 1145
SUPPLEMENTARY DATA 1147
REFERENCES 1147
The Role of Transtympanic Dilatation of the Eustachian Tube During Chronic Ear Surgery 1149
Key points 1149
INTRODUCTION 1149
Technique 1150
Case study 1152
Anatomic Considerations: Relationship of the Carotid to the Eustachian Tube 1153
Anatomic Considerations: Anatomy of Protympanum 1155
Safety Considerations 1157
RESULTS 1158
DISCUSSION 1158
SUMMARY 1161
SUPPLEMENTARY DATA 1161
REFERENCES 1161
Transnasal Endoscopic Eustachian Tube Surgery 1163
Key points 1163
INTRODUCTION 1163
CONTENT/DISCUSSION 1164
SUMMARY 1169
SUPPLEMENTARY DATA 1170
REFERENCES 1170
Endoscopic Facial Nerve Surgery 1173
Key points 1173
INTRODUCTION 1173
ANATOMICAL CONSIDERATIONS 1174
Precochleariform Segment of Tympanic Portion of Facial Nerve 1174
Geniculate Ganglion 1174
Greater Petrosal Nerve 1175
Postcochleariform Segment of Tympanic Portion of Facial Nerve 1177
Intralabyrinthine portion of facial nerve 1177
TRANSCANAL ENDOSCOPIC APPROACHES TO THE FACIAL NERVE 1177
Endoscopic Transcanal Transpromontorial Approach 1178
Surgical steps 1179
Endoscopic Transcanal Suprageniculate Approach 1179
Surgical steps 1182
Postoperative care and follow-up 1182
Endoscopic Transcanal Facial Nerve Decompression 1182
Surgical steps 1183
Postoperative care and follow-up 1184
DISCUSSION 1184
SUMMARY 1186
REFERENCES 1186
Endoscopic-Assisted Repair of Superior Canal Dehiscence 1189
Key points 1189
INTRODUCTION 1189
DIAGNOSIS OF SUPERIOR CANAL DEHISCENCE 1190
Audiometric Testing 1191
Vestibular Evoked Myogenic Potential 1191
Diagnostic Imaging 1191
ROLE OF ENDOSCOPE IN MIDDLE FOSSA CRANIOTOMY APPROACH SUPERIOR CANAL DEHISCENCE REPAIR 1191
PREOPERATIVE PLANNING 1194
MASSACHUSETTS EYE AND EAR INFIRMARY ENDOSCOPIC-ASSISTED REPAIR OF SUPERIOR CANAL DEHISCENCE 1196
ENDOSCOPIC EQUIPMENT 1198
SURGICAL OVERVIEW OF ENDOSCOPIC-ASSISTED MIDDLE FOSSA CRANIOTOMY SUPERIOR CANAL DEHISCENCE REPAIR 1198
SUMMARY 1201
REFERENCES 1202
Endoscopic Management of Middle Ear and Temporal Bone Lesions 1205
Key points 1205
INTRODUCTION 1205
TECHNIQUE 1206
MIDDLE EAR PARAGANGLIOMA 1207
MIDDLE EAR ADENOMA 1209
PETROUS APEX CHOLESTEROL GRANULOMA 1210
OTHER LESIONS 1211
SUMMARY 1212
REFERENCES 1213
Outcomes Following Endoscopic Stapes Surgery 1215
Key points 1215
INTRODUCTION 1215
SURGICAL TECHNIQUE 1216
INTRAOPERATIVE ISSUES 1217
Audiologic Outcomes 1220
Patient Outcomes 1223
SUMMARY 1224
SUPPLEMENTARY DATA 1224
REFERENCES 1224
The Fully Endoscopic Acoustic Neuroma Surgery 1227
Key points 1227
INTRODUCTION 1227
TRANSCANAL TRANSPROMONTORIAL ENDOSCOPIC APPROACH TO THE INTERNAL AUDITORY CANAL 1228
Indications 1229
Surgical Technique 1229
Postoperative Care 1232
DISCUSSION 1232
SUMMARY 1235
REFERENCES 1235
Incorporating Endoscopic Ear Surgery into Your Clinical Practice 1237
Key points 1237
INTRODUCTION 1238
INDICATIONS FOR ENDOSCOPIC EAR SURGERY 1240
OPTIMIZED SURGICAL ERGONOMICS FOR ENDOSCOPIC EAR SURGERY 1242
Operating Room Setup 1242
Hand Positioning and Placement of the Endoscope 1242
Left Versus Right Ears 1243
INSTRUMENTATION 1243
Light Sources and Camera Systems 1243
Endoscopes 1243
Dissection Instruments 1243
Pearls and Pitfalls 1245
SUMMARY 1250
REFERENCES 1251
Endoscopic Techniques in Tympanoplasty 1253
Key points 1253
INTRODUCTION 1253
HAS THE ENDOSCOPE OUTPERFORMED THE MICROSCOPE? 1254
ENDOSCOPIC TYMPANOPLASTY AND GRAFTING SELECTION 1256
Temporalis Muscle Fascia 1256
Cartilage and Perichondrium 1256
Fat 1257
SURGICAL TECHNIQUE 1258
Step 1: Optimizing Hemostasis 1258
Step 2: Graft Harvest 1258
Step 3: Preparing the Tympanic Membrane and Approach to the Middle Ear 1258
Step 4: Ossicular Chain and Ventilation Routes Assessment 1260
Step 5: Grafting 1261
SUMMARY 1261
SUPPLEMENTARY DATA 1261
REFERENCES 1261
Endoscopic Management of Attic Cholesteatoma 1265
Key points 1265
INTRODUCTION 1265
MATERIAL AND METHODS 1266
RESULTS 1266
DISCUSSION 1267
SUMMARY 1269
REFERENCES 1269
Outcomes in Endoscopic Ear Surgery 1271
Key points 1271
INTRODUCTION 1271
OBSERVATIONAL ENDOSCOPIC EAR SURGERY FOR CHOLESTEATOMA: ANALYSIS OF OUTCOMES 1273
OPERATIVE ENDOSCOPIC EAR SURGERY/TRANSCANAL ENDOSCOPIC EAR SURGERY FOR CHOLESTEATOMA: ANALYSIS OF OUTCOMES 1276
ENDOSCOPIC EAR SURGERY FOR PEDIATRIC CHOLESTEATOMA 1279
ENDOSCOPIC MYRINGOPLASTY, TYMPANOPLASTY, OSSICULOPLASTY 1282
ENDOSCOPIC COCHLEAR IMPLANTATION 1282
ENDOSCOPIC SKULL BASE SURGERY 1284
ENDOSCOPIC EAR SURGERY AT MASSACHUSETTS EYE AND EAR INFIRMARY 1284
NEED FOR PROSPECTIVE AND SAFETY STUDIES 1285
SUMMARY 1286
REFERENCES 1286
Size as a Risk Factor for Growth in Conservatively Managed Vestibular Schwannomas 1291
INTRODUCTION 1291
METHOD 1292
RESULTS 1292
DISCUSSION 1293
SUMMARY 1294
REFERENCES 1294
Index 1297