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Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
The medial pterygoid has a similar typical presentation in the apes, originating from the medial surface of the lateral pterygoid plate and sometimes the pterygoid fossa to insert onto the medial side of the mandible (Raven 1950; Miller 1952; Gibbs 1999; Diogo et al. 2010, 2012, 2013a,b, 2017). It may also have origins from the pyramidal process of the palatine, the maxillary tuberosity, and/or the pterygomandibular raphe in orangutans (Boyer 1939; Gibbs 1999; Diogo et al. 2013b).
Anatomy of the Skull Base and Infratemporal Fossa
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Also arising from two heads, the larger of these arises from the deep (medial) surface of the lateral pterygoid plate; a small slip joins from the tuberosity of the maxilla and the pyramidal process of the maxilla, initially passing over the inferior free edge of the lateral pterygoid. Angled laterally, posteriorly and inferiorly, it inserts into the angle of the mandible (Figure 98.2), acting to close the mouth and move the mandible towards the opposite side in chewing. It is innervated by the mandibular nerve.
Thulium laser in stapedotomy surgery
Published in Acta Oto-Laryngologica, 2022
Edoardo Covelli, Haitham H. Elfarargy, Chiara Filippi, Valerio Margani, Luigi Volpini, Maurizio Barbara
Under general anesthesia, a transcanal approach was used to elevate the tympano-meatal flap. Then the operation proceeded by adequate exposure of the oval fossa, horizontal Fallopian canal, the pyramidal process, and the stapedial tendon. After identification of the stapes footplate, a reversal-steps stapedotomy was applied. Multiple overlapped Thulium laser shots (from 4 to 5 shots) were used in group A to make a 0.6 mm hole in the stapes footplate. On the other hand, only one Thulium laser shot was used to carbonize the footplate bone in group B; then, the surgery continued with a manual perforator to make a 0.6 mm hole in the stapes footplate. A 5.50 mm long, 0.5 mm wide platinum Teflon prosthesis (Audio Technologies, Piacenza, Italy) was then placed in the calibrated footplate hole without interposition and immediately crimped on the long process of the incus. Then, a Thulium laser was used in both groups to disarticulate the incudo-stapedial joint (3 shots), vaporize the stapedial tendon (2 shots), and the posterior stapedial crus (3 shots) to remove the stapes supra-structure.
Surgical treatment of otosclerosis using a unique stapes prosthesis without a hook
Published in Acta Oto-Laryngologica, 2021
Sho Kanzaki, J. Kanzaki, K. Ogawa
The first author, an experienced surgeon, performed all of the operations in this series. Our general stapedectomy/stapedotomy techniques are as follows. First, a local anaesthetic agent is injected into the 4-quadrant canal. We make a permeatal incision, elevate the tympanic membrane and confirm stapes fixation. If the stapes footplate is mobile, we do not perform stapedectomy. In most cases, we perform a surgical mobilization of the stapes or tympanoplasty. A curette is used to remove part of the scutum to visualize the pyramidal process and facial nerve. After separating the incudostapedial joint, the stapedial tendon and posterior crura of the stapes are drilled using a skeeter drill. The stapes is then down-fractured. A stapedotomy is made in the centre of the footplate using a skeeter drill. The fenestration size is 1.0–1.2 mm to avoid a bony overgrowth of the oval window (Figure 2). Next, we place perichondrium from the tragus cartilage over the opening window of the stapes and insert the stapes prosthesis over this perichondrial tissue. We touch the prothesis and check the round window reflex to confirm the mobility of the prosthesis. Finally, we place gel foam and fibrin glue around the prosthesis to avoid slippage of the perichondrium. The tympanomeatal flap is then returned to its normal position.