Anatomy of the temporal bone with surgical implications

Anatomy of the temporal bone with surgical implications

Otolaryngology Head and Neck Surgery Volume 112 Number 5 COURSE4518-1 One-period course ($20) Instruction Courses-- Wednesday Room NOCC-80 1:15-2:...

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Otolaryngology Head and Neck Surgery

Volume 112 Number 5

COURSE4518-1 One-period course ($20)

Instruction Courses-- Wednesday

Room NOCC-80 1:15-2:15

COURSE 4520- I

One-period course ($20)

P 165

Room NOCC-82 1:15-2:15

Tinnitus Update: Treatment Strategies

Pediatric Otologic Surgery--Problems and Pragmatic

MICHAEL J. LAROUERE,MD, and JOHN J. ZAPPIA,MD

Solutions

Farmington Hills, Mich., and Hinsdale, III.

NANCY SCULERATI,MD, and RONALDA. HOFFMAN, MD

Educational objectives: To understand the various etiologies of tinnitus and establish an efficient diagnostic plan and to develop an effective treatment strategy for patients complaining of tinnitus.

Over 85% of patients with an otologic problem suffer from tinnitus. The evaluation of patients with tinnitus will be discussed, including key points in the history and physical examination that can lead to an identifiable cause of the tinnitus. When to proceed to special testing, including ABR, CT, MRI, MRA, or angiography is outlined. Treatment strategies related to tinnitus patients will be discussed in detail. Special emphasis will be placed on masking, drug therapy, biofeedback, surgical treatment, and electrical suppression of tinnitus. Newer techniques, including three-dimensional auditory recordings, will also be presented. Treatment techniques and overall results will be highlighted. COURSE 4519-2 Two-period course ($40)

Room NOCC-81 1:15-3:30

New York, N.Y.

Educational objective: To improve operative planning of ear surgery in children.

This course will provide a practical overview of operative decision making in pediatric otology. Specific operative indications, techniques, and methods of management of complications will be discussed. The topics covered range from myringotomy and tube insertion to exploration for perilymphatic fistula, and cochlear implantation in children. Considerable attention is given to problems of the chronic ear, including timing of repair, use of autografts and synthetics, and canal wall up versus canal wall down procedures. The m a n a g e m e n t of retraction p o c k e t s and cholesteatoma is discussed.

C O U R S E 4521 -I One-period course ($20)

Room NOCC-83 1:15-2:15

Anatomy of the Temporal Bone with Surgical Implications

Medical Aspects of Scuba Diving

A. JULIANNAGULYA,MD

GARY D. BECKER,MD, and G. JOSEPHPARELL,MD

Washington, D.C.

Panoroma City, Calif., and Panama City, Fla.

Educational objectives: To conceptualize the temporal bone three dimensionally, approach temporal bone surgery rationally, and have a better appreciation of the courses and exhibits relating to the temporal bone.

Educational objectives: To more fully understand how the underwater environment affects the scuba diver and to diagnose and treat common medical disorders resulting from scuba diving.

The safe completion of otologic surgical procedures demands that the surgeon possess an intimately detailed knowledge of the complex three-dimensional anatomy of the temporal bone. This course, based on the book of the same title, will review those aspects of special significance to the surgeon. Illustrative materials will include slides of serially sectioned (both horizontally and vertically) human temporal bones, three-dimensional slides of the human temporal bone undergoing serial sectioning in the horizontal plane, threedimensional slides of a transmastoid temporal bone dissection, and intraoperative views. The middle ear, mastoid, labyrinth, internal auditory canal, and skull base will be visualized from the lateral, posterior cranial fossa, and middle cranial fossa aspects of the temporal bone. This course is designed especially for those just embarking on temporal bone surgery, but seasoned practitioners may find it an interesting and informative review. The aim of the course is to develop an integrated, three-dimensional appreciation of the anatomy of the temporal bone that will serve the surgeon in performing temporal bone procedures.

There are more than 3 million recreational scuba divers in the United States and more than 250,000 are trained and certified each year. The otolaryngologist informed about the subaquatic environment will be better able to answer patients' diving-related questions, evaluate injuries, and advise regarding who should not dive, and when to return to diving after an injury. By far the most common diving-related injuries involve the ears and paranasal sinuses. The first part of this presentation discusses the pathophysiology, symptoms, diagnostic evaluation, treatment, and prevention of sinus and ear barotrauma, as well as related otolaryngologic injuries. Basic diving physics is briefly reviewed. The second part emphasizes less common but often more emergent nonotolaryngologic injuries, including pulmonary overpressure accidents, decompression sickness, and marine environmental hazards. Pathophysiology, symptoms, diagnostic evaluation, treatment, and prevention are discussed. Recommendations are made regarding medical standards for recreational scuba diving.