China
Africa
Explore chapters and articles related to this topic
Metabolic Bone Disease and Systemic Disorders of the Temporal Bone
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Victoria Alexander, Parag Patel
Bisphosphonates to prevent bone reabsorption and fractures (may slow hearing decline)Non-steroidal anti-inflammatory drugs (NSAIDs) for bone painHearing aid, cochlear implantation (CI)Middle ear surgery usually ineffective
General, Urological and Gynaecological Surgery
Published in Elizabeth Combeer, The Final FRCA Short Answer Questions, 2019
This question is virtually identical to one from 2006, and then recurs in 2016. I am slightly unclear as to why the College underlined the word laparoscopy when they clearly wanted you to discuss issues related to the position of the patient. Generally, though, if they mention the type of operation a patient is having, it is for a reason. Cancer surgery? Minimal opportunity for delaying for optimisation, consider impact of radio- and chemotherapy. Pelvic or lower abdominal laparoscopic surgery? Often Trendelenberg position, with its attendant issues. Ear surgery? Consider nausea and vomiting. Day case surgery? Think about optimising analgesia and antiemesis in order to get the patient out within 24 hours. However, note that the College was approving of those who had used a ‘good systematic approach’.
Otoendoscopy
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
David A. Bowdler, Annabelle C.K. Leong, David D. Pothier
In otology, the operating microscope revolutionized ear surgery by improving the accuracy and safety of operative procedures. Indeed, the use of the microscope with microinstruments led to otology being one of the first fields of minimally invasive surgery. The advantages of the operating microscope are obvious: it delivers a stable image in the familiar head-on view with the ability to vary magnification while freeing both of the surgeon’s hands to operate. However, its straight-line view is also the microscope’s main limitation as it is unable to navigate around anatomical corners to provide a wide and variable direction of view, unlike the endoscope. Modern advances in endoscope design have provided a new tool for the examination of anatomical structures in the middle ear and more challenging applications extend to neuro-otological operations such as the removal of acoustic neuromas. A spectrum of approaches currently exists between totally microscopic ear surgery and totally endoscopic ear surgery, with an increasing number of otologists using the endoscope to some extent during an otologic procedure. This chapter deliberately concentrates on the otoendoscope, often to the exclusion of the microscope, as traditional or conventional methods are covered elsewhere. The authors vary in their views from mixed usage to a totally endoscopic approach but all believe that the otoendoscope is an essential piece of equipment for the best practice of otology. Each individual must decide his or her own position with respect to the degree of usage of the otoendoscope.
Transmembranous piston extrusion after stapedotomy: A rare complication
Published in Acta Oto-Laryngologica Case Reports, 2023
Hester B. E. Elzinga, Hans G. X. M. Thomeer
Since the early sixties of the past century middle ear surgery with stapes replacement procedure has been the mainstay of treatment of otosclerosis [1–4]. In the beginning stapes mobilization or semicircular canal fenestration were techniques leading to (partial) hearing improvement, though with a considerable recurrence rate and complications (such as sensorineural hearing loss, vestibular complaints) [5,6]. Improvements in these techniques resulted first in stapedectomy and later to stapedotomy: a broadly accepted and in most cases successful surgical intervention, resulting in a rather acceptable long-term resolution of the conductive component in the hearing impairment [3]. Need for revision surgery is rare (<5%) and is indicated in cases of recurrence of conductive hearing loss [7]. Main reasons underlying this failure is a destabilized prosthesis (e.g. incus erosion, inappropriate prosthesis length) or rather a ‘fixed’ prosthesis [7–9]. Revision surgery is then indicated to alleviate the air-bone gap (ABG) . However, the procedure may be challenging, and hearing results are inferior to results after primary surgery. Additionally, it is associated with an increased risk of sensorineural hearing loss due to cochlear trauma [6,7,9–11].
A simple and convenient 3D printed temporal bone model for drilling simulating surgery
Published in Acta Oto-Laryngologica, 2022
Zhi-Ming Yuan, Xiao-Dong Zhang, Shou-Wu Wu, Zhong-Zhu Nian, Jun Liao, Wen Lin, Li-Ming Zhuang
Temporal bone surgery training should be staged and hierarchical. For beginners who have just graduated, completed theoretical study and are required for surgery training, the first is to carry out the training on the contour of the mastoid process and be familiar with the feelings and techniques of surgery, then to master facial nerve surgery, and finally to involve middle ear surgery. This is a step by step tutorial. In this investigation, all participants believed that this model could well restore the anatomical morphology of the temporal bone, and had a good haptic sensation in simulating surgery, so it is a good training model for simulating surgery. At the same time, this model has obvious defects, mainly the fine structural details of facial nerves and middle ear could not be identified. However, it is characterized by simple modeling, easy accessibility, low cost and easy promotion, which is suitable for beginners’ drilling training in otology.
Alteration of the relative vibration of the round window membrane after implantation of a direct acoustic cochlear implant
Published in International Journal of Audiology, 2020
Christiane D’hondt, Jan Wouters, Nicolas Verhaert
Direct Acoustic Cochlear Implants (DACI) are a recent category of acoustic hearing implants. They were developed to address the gap in treatment options for patients with severe to profound mixed hearing loss (Häusler et al. 2008). These patients receive inadequate benefit from hearing aids, bone conduction (BC) implants or middle ear surgery, while in many cases the sensorineural component of their hearing loss is not severe enough to warrant cochlear implantation. Over the past few years the safety and efficacy of DACI have been established by several clinical studies (Busch et al. 2013; Häusler et al. 2008; Kludt et al. 2016, 2017; Lenarz et al. 2014, 2013; Schwab et al. 2015). The DACI investigated in our study is an active semi-implantable hearing system that is composed of two parts. The external part comprises the digital sound processor and a radio-frequency coil. The implanted part is an implant with actuator, which is mounted in the mastoid cavity with a fixation system (Figure 1). A conventional stapes prosthesis is attached to the implant’s actuator. The vibrating actuator drives the perilymph via the stapes prosthesis through a stapedotomy opening. The implant does not attach to the middle ear ossicles and thus bypasses any existing middle ear problems and compensates the sensorineural hearing loss with amplified vibrations. The DACI concept, method and implantation were explained in detail by Häusler et al. (2008), while the DACI system used in our study is described in more detail by Lenarz et al. (2013).