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Communication Skills Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Explain the procedure in terms of intended benefit, dependent on disease extent. Mastoidectomy is an operation usually performed with an incision behind the ear, to establish the extent of disease and clear all of the skin cells. The bones of hearing may or may not need to be addressed. If they do, this can be done at the time or as a second-stage procedure. Any holes in or retracted areas of the ear drum can also be addressed.
Chronic Otitis Media
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
As well as the risk of residual or recurrent disease, mastoidectomy also carries a risk of worse hearing (including a dead ear), persistent otorrhoea (usually from a failure of reconstruction leading to exposed mucosal epithelium), taste disturbance, nausea, vertigo, tinnitus, or facial palsy.
Otorhinolaryngology (ENT)
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Types➣ Cortical mastoidectomy➣ Radical mastoidectomy
Examination of risk factors for postoperative vestibular symptoms in patients with cholesteatoma
Published in Acta Oto-Laryngologica, 2022
Takaaki Kobayashi, Shusuke Iwamoto, Toshihito Sahara, Yujiro Hoshi, Anjin Mori, Hajime Koyama, Takeshi Fujita, Mitsuo P. Sato, Yasuhiro Osaki, Katsumi Doi
In the primary operation for cholesteatoma, the incidence of postoperative dizziness at our hospital was 13.9%. The issues so far in cholesteatoma have been reported to be the rate of residual/recurrence of the lesion and hearing improvement results; few studies have discussed postoperative vestibular symptoms. This study is the first to investigate the incidence of dizziness in detail based on the STAM system and staging, as well as the findings of bone destruction. In our previous study, we reported that patients who underwent canal wall down mastoidectomy (CWD) had a higher incidence of vestibular symptoms than those who underwent canal wall up mastoidectomy (CWU) [7]. The reason for this was that the surgical invasion was large in CWD cases and thus it was likely that the impact of drilling was transmitted more to the vestibular organ; further, the extent of cholesteatoma lesions was relatively larger in CWD cases. In this study, a significant difference was observed in the comparison of the number of cholesteatoma regions based on the STAM system, with 1.73 regions in CWU cases and 2.82 regions in CWD cases (p < .01). Therefore, it is difficult to simply compare the risk of dizziness due to variations in mastoidectomy.
Cochlear implant surgery: Learning curve in virtual reality simulation training and transfer of skills to a 3D-printed temporal bone – A prospective trial
Published in Cochlear Implants International, 2021
Martin Frendø, Andreas Frithioff, Lars Konge, Mads Sølvsten Sørensen, Steven A. W. Andersen
After the introduction, participants completed the intervention training, which consisted of four separate training sessions (i.e. distributed practice) comprising a total of 18 VR simulation procedures. The training sessions were timed with 7–14 days between sessions for adequate distribution of practice (Andersen et al., 2018). During these 18 VR simulation procedures, participants had access to an on-screen dissection guide but no tutoring (Frendø et al., 2019). Each procedure was identical and consisted of thinning of the posterior wall of the ear canal, safely identifying the facial nerve and chorda tympani, and drilling of a posterior tympanotomy on a case scenario in the simulator where the basic mastoidectomy had already been performed. The posterior tympanotomy was followed by CI-insertion. The basic mastoidectomy was pre-drilled to isolate the effect of the CI surgery training rather than mastoidectomy skills.
Delayed postoperative complications in 624 consecutive cochlear implantation cases
Published in Acta Oto-Laryngologica, 2021
Lusen Shi, Guangjie Zhu, Dengbin Ma, Chengwen Zhu, Jie Chen, Xiaoyun Qian, Xia Gao
The area for the CI was first infiltrated with epinephrine as the local anesthetic, and then an inverted ‘S’ or ‘C’-shaped incision of 4.5–5 cm was made to the posterior auricular sulcus from the mastoid tip to the superior border of the pinna. The flap made with this incision fully exposed the position of the external processor and the mastoid cavity. In the second-layer, the ‘Y’-shaped incision was made to cut the muscle and the periosteum. These incisions resulted in a double flap, and a small groove was then drilled onto the surface of the skull for the receiver in accordance with the shape and dimensions of the implant. A limited mastoidectomy was then performed, and for easier middle ear visualization we actively and adequately exposed the facial nerve and chorda tympani nerve during the mastoidectomy. The electrode was inserted into the cochlea through the round window or through a second hole drilled under the cochleostomy, near the round window. The usual pressed ear dressing was used after the surgery, and three days later it was replaced with a self-adhesive elastic bandage. The dressing was removed after 7–10 days.