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Surgical and medical management of otosclerosis
Otolaryngology Head and Neck Surgery
Volume 112 Number 5
COURSE 4641 - i
One-period course ($20)
Instruction Courses-- Wednesday
Room NOCC- 104 2:30-3:30
Surgical and Medical M a n a g e m e n t of Otosclerosis
COURSE 4704- I
One-period course ($20)
P 183
Room NOCC-50 3:45-4:45
Nasal Reconstruction--Something Old, Something N e w
JEAN-BERNARDCAUSSE,MD, and ROBERTVINCENT, MD
MARK R. KLINGENSMITH,MD, and VICTOR MARKS, MD
B~ziers, France
Jeanneffe and DanviLLe, Pa.
Educational objectives: To instruct participants in easier and safer methods of performing otosclerosis surgery (focusing on tips for avoiding complications) and on medical treatment of otosclerosis.
Educational objectives: To become familiar with the options for nasal reconstruction and apply these methods in the repair o f various defects of the nose with excellent cosmetic results.
Giving tips helping the otosclerosis surgeon to perform easier and still very safe surgery is our concern. Sharing our experience of about 50,000 surgical cases performed in our Institute of Otology in B6ziers-Colombiers is our pleasure. Rebuilding kind of an annular ligament of the footplate around the lower tip of the prosthesis, which acts like a shock absorber and a "trampoline," and rebuilding the stapes tendon can easily be performed if the tips are understood. Is sodium fluoride efficient? Is diphosphonate useful to prevent future deterioration of the hearing? Videotapes, slides, and comments also presented by a less experienced surgeon than the senior author will keep the discussion exciting.
Many options exist for reconstruction of nasal defects. Traditional methods usually yield satisfactory results; however, the anatomic complexity of the region may require subtle technique variations and complex procedures to prevent distortion and aesthetically unacceptable results. Based on extensive experience, we have developed a systematic approach to repair of nasal defects employing traditional and less traditional methods. This course will emphasize a graduated approach to nasal repair. We will review the repair of a variety of nasal defects ranging from small superficial defects, to larger defects involving more than 1 subunit, to full thickness defects and heminasal reconstruction. A variety of methods will be demonstrated: (1) full-thickness skin grafts, (2) composite grafts, (3) bilobed flaps, (4) rhombic flaps, (5) banner flaps, (6) dorsal rotation flaps, and (7) the forehead flap. Less traditional methods presented will include: (1) an island rotation flap for nasal tip defects, (2) two-stage nasolabial flap, and (3) Washio Tempero retroauricular flap. The use of each of these options will be presented in detail, with an emphasis on indications, technical details regarding design and transfer, caveats on their use and their limitations. Options for the replacement of cutaneous coverage, cartilaginous support and inner lining will be emphasized. We will present principles of cosmetic repair with an emphasis on aggressive thinning and exact sculpting of flaps at the time of initial transfer, thus minimizing the need for subsequent revision. In summary, a multitude of options for nasal repair including traditional and relatively new concepts coupled with surgical principles designed to obtain optimal cosmetic resuits will be presented.
COURSE 4703-1
One-period course ($20)
Room NOCC-D-3 3:45-4:45
Endonasal Frontal Sinus Surgery MARK MAY, MD, and BARRYSCHAITKIN, MD
Pittsburgh, Pa.
Educational objectives: To select appropriate candidates for endonasal frontal surgery and to understand the endonasal approach to the frontal sinus.
Draf described an endonasal microscopic method to achieve median drainage of the frontal sinus as an alternative to an external procedure. We have modified the Draf approach but use endoscopic guidance. Two hundred fourteen patients with inflammatory disease of the nasofrontal-frontal region were operated on using endonasal endoscopic technique over a 7-year period (1987 to 1994). Case selection, surgical technique, results, and complications are presented. Based on a follow-up (6 to 24 months) the results indicate that the endonasal approach is a viable alternative to the classic external approach.
Volume 112 Number 5
COURSE 4641 - i
One-period course ($20)
Instruction Courses-- Wednesday
Room NOCC- 104 2:30-3:30
Surgical and Medical M a n a g e m e n t of Otosclerosis
COURSE 4704- I
One-period course ($20)
P 183
Room NOCC-50 3:45-4:45
Nasal Reconstruction--Something Old, Something N e w
JEAN-BERNARDCAUSSE,MD, and ROBERTVINCENT, MD
MARK R. KLINGENSMITH,MD, and VICTOR MARKS, MD
B~ziers, France
Jeanneffe and DanviLLe, Pa.
Educational objectives: To instruct participants in easier and safer methods of performing otosclerosis surgery (focusing on tips for avoiding complications) and on medical treatment of otosclerosis.
Educational objectives: To become familiar with the options for nasal reconstruction and apply these methods in the repair o f various defects of the nose with excellent cosmetic results.
Giving tips helping the otosclerosis surgeon to perform easier and still very safe surgery is our concern. Sharing our experience of about 50,000 surgical cases performed in our Institute of Otology in B6ziers-Colombiers is our pleasure. Rebuilding kind of an annular ligament of the footplate around the lower tip of the prosthesis, which acts like a shock absorber and a "trampoline," and rebuilding the stapes tendon can easily be performed if the tips are understood. Is sodium fluoride efficient? Is diphosphonate useful to prevent future deterioration of the hearing? Videotapes, slides, and comments also presented by a less experienced surgeon than the senior author will keep the discussion exciting.
Many options exist for reconstruction of nasal defects. Traditional methods usually yield satisfactory results; however, the anatomic complexity of the region may require subtle technique variations and complex procedures to prevent distortion and aesthetically unacceptable results. Based on extensive experience, we have developed a systematic approach to repair of nasal defects employing traditional and less traditional methods. This course will emphasize a graduated approach to nasal repair. We will review the repair of a variety of nasal defects ranging from small superficial defects, to larger defects involving more than 1 subunit, to full thickness defects and heminasal reconstruction. A variety of methods will be demonstrated: (1) full-thickness skin grafts, (2) composite grafts, (3) bilobed flaps, (4) rhombic flaps, (5) banner flaps, (6) dorsal rotation flaps, and (7) the forehead flap. Less traditional methods presented will include: (1) an island rotation flap for nasal tip defects, (2) two-stage nasolabial flap, and (3) Washio Tempero retroauricular flap. The use of each of these options will be presented in detail, with an emphasis on indications, technical details regarding design and transfer, caveats on their use and their limitations. Options for the replacement of cutaneous coverage, cartilaginous support and inner lining will be emphasized. We will present principles of cosmetic repair with an emphasis on aggressive thinning and exact sculpting of flaps at the time of initial transfer, thus minimizing the need for subsequent revision. In summary, a multitude of options for nasal repair including traditional and relatively new concepts coupled with surgical principles designed to obtain optimal cosmetic resuits will be presented.
COURSE 4703-1
One-period course ($20)
Room NOCC-D-3 3:45-4:45
Endonasal Frontal Sinus Surgery MARK MAY, MD, and BARRYSCHAITKIN, MD
Pittsburgh, Pa.
Educational objectives: To select appropriate candidates for endonasal frontal surgery and to understand the endonasal approach to the frontal sinus.
Draf described an endonasal microscopic method to achieve median drainage of the frontal sinus as an alternative to an external procedure. We have modified the Draf approach but use endoscopic guidance. Two hundred fourteen patients with inflammatory disease of the nasofrontal-frontal region were operated on using endonasal endoscopic technique over a 7-year period (1987 to 1994). Case selection, surgical technique, results, and complications are presented. Based on a follow-up (6 to 24 months) the results indicate that the endonasal approach is a viable alternative to the classic external approach.