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Evaluation and management of vestibular disorders in children
Otolaryngology Head and Neck Surgery Volume 112 Number 5
COURSE 3832-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-95 4:15-5:15
Endoscopy, KTP Laser, and Facial Plastic Surgery DOUGLAS D. DEDO, MD Palm Beach, Fla.
Educational objectives: To understand the anatomy of the deep plane facelift and the theory of its usefulness and to decide whether endoscopic laser surgery offers new and usable additions to the present surgical armamentarium.
This is an advanced course for surgeons who are familiar with widely undermined facelifts, suh-SMAS dissections, and parotid surgery. The technique developed by the author of KTP laser-assisted endoscopic face and blepharoplasty surgery will be presented. The only surgical disciplin e that has not adopted the technology of endoscopy is facial plastic and cosmetic surgery. As otolaryngologists we are familiar with the advantages and increased precision of operating in the sinuses with endoscopic control. Similarly, the advantages of being able to see at the end of the dissection when operating in close proximity to the facial nerve are obvious. The recent development of sub-SMAS and composite facelift surgery to correct the ptotic cheek and shorten the cheek lip fold has suddenly focused the necessity for new technology that shortens operating time and facilitates surgery. Anyone who has dissected on top of the masseteric fascia into the cheek of the midface is familiar with the annoying bleeding that occurs and the close proximity of the facial nerve. Cadaver dissections, clinical experience, and the rationale for the use of endoscopes and the KTP laser will be profusely illustrated. The expansion of this technology to lower lid blepharoplasty was a natural development, considering the approach used for endoscopy of the zygomatic ligament; as a result, any lower lid operation that can be done transconjunctivally is a candidate for endoscopy.
COURSE 3834-1 One-period course ($20)
Room NOCC-97 4:15-5:15
Evaluation and Management of Vestibular Disorders in Children JACK J. WAZEN, MD, and JOSEPHHADDAD, MD New York, N.Y.
Educational objectives: To review the different causes of vestibular symptoms in children and to follow a proposed protocol to work up, diagnose, and treat.
The diagnosis and treatment of dizziness, vertigo, and dysequilibrium in children remain a challenging task. The purpose of this course is to review the incidence of vesti-
P 155
bular disorders in children presenting to the Columbia Presbyterian Medical Center and Babies Hospital in New York and to review the most common of the disorders, their presenting signs and symptoms, the appropriate testing required, and their respective treatment plans. Both peripheral and central causes of vestibular symptoms will be covered. A decision-making tree will be proposed to give the otolaryngologist who sees an occasional child with dizziness a quick, systematic management protocol.
COURSE 3837-1 One-period course ($20)
Room NOCC- 1O0 4:15-5:15
Forensic Audiology: Assessment of the Patient/Litigant MARC B. KRAMER,PhD New York, N.Y,
Educational objectives: To critically review the audiologic data and the assessment technique utilized in evaluating a patient~litigant and to be more conversant with the role of an expert witness with respect to allegations of hearing loss.
With increasing frequency, otologists are called on to render expert opinions regarding the auditory status of litigants. Such opinions must be based on a thorough examination of all the pertinent facts and rely heavily on the audiometric data. Whereas patients generally seek relief from pain and suffering or improvement of their hearing, in litigation the patient/litigant may seek recovery in a monetary form, the magnitude of which may depend on the clinical history offered and responses on audiometric testing. It is the ability of the expert to evaluate the efficacy of both the audiologic results and the assessment procedure itself that is crucial to the formulation of a carefully considered opinion. The course will draw on two decades of clinical experience in evaluating hearing loss litigants and their claims. The course has a twofold purpose: (1) to raise to the consciousness the potential for hidden exaggeration on the part of litigants and (2) to review a variety of procedures that should be considered to accurately assess these patients and to identify or rule out functional components. Relevant examples will be drawn from patient/litigant experiences. This course should prove to be of equal value to both the examining clinician and the reviewing expert. Topics to be covered include exaggeration: a realistic view; an index of suspicion: the concept; possible indications of exaggeration found during patient assessment; classic audiologic findings suggestive of exaggeration; the use of special tests; recommended procedures to expedite the identification of exaggeration; the clinical resolution of discrepancies; recommendations for preparing reports and testimony; and the role of the expert witness.
COURSE 3832-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-95 4:15-5:15
Endoscopy, KTP Laser, and Facial Plastic Surgery DOUGLAS D. DEDO, MD Palm Beach, Fla.
Educational objectives: To understand the anatomy of the deep plane facelift and the theory of its usefulness and to decide whether endoscopic laser surgery offers new and usable additions to the present surgical armamentarium.
This is an advanced course for surgeons who are familiar with widely undermined facelifts, suh-SMAS dissections, and parotid surgery. The technique developed by the author of KTP laser-assisted endoscopic face and blepharoplasty surgery will be presented. The only surgical disciplin e that has not adopted the technology of endoscopy is facial plastic and cosmetic surgery. As otolaryngologists we are familiar with the advantages and increased precision of operating in the sinuses with endoscopic control. Similarly, the advantages of being able to see at the end of the dissection when operating in close proximity to the facial nerve are obvious. The recent development of sub-SMAS and composite facelift surgery to correct the ptotic cheek and shorten the cheek lip fold has suddenly focused the necessity for new technology that shortens operating time and facilitates surgery. Anyone who has dissected on top of the masseteric fascia into the cheek of the midface is familiar with the annoying bleeding that occurs and the close proximity of the facial nerve. Cadaver dissections, clinical experience, and the rationale for the use of endoscopes and the KTP laser will be profusely illustrated. The expansion of this technology to lower lid blepharoplasty was a natural development, considering the approach used for endoscopy of the zygomatic ligament; as a result, any lower lid operation that can be done transconjunctivally is a candidate for endoscopy.
COURSE 3834-1 One-period course ($20)
Room NOCC-97 4:15-5:15
Evaluation and Management of Vestibular Disorders in Children JACK J. WAZEN, MD, and JOSEPHHADDAD, MD New York, N.Y.
Educational objectives: To review the different causes of vestibular symptoms in children and to follow a proposed protocol to work up, diagnose, and treat.
The diagnosis and treatment of dizziness, vertigo, and dysequilibrium in children remain a challenging task. The purpose of this course is to review the incidence of vesti-
P 155
bular disorders in children presenting to the Columbia Presbyterian Medical Center and Babies Hospital in New York and to review the most common of the disorders, their presenting signs and symptoms, the appropriate testing required, and their respective treatment plans. Both peripheral and central causes of vestibular symptoms will be covered. A decision-making tree will be proposed to give the otolaryngologist who sees an occasional child with dizziness a quick, systematic management protocol.
COURSE 3837-1 One-period course ($20)
Room NOCC- 1O0 4:15-5:15
Forensic Audiology: Assessment of the Patient/Litigant MARC B. KRAMER,PhD New York, N.Y,
Educational objectives: To critically review the audiologic data and the assessment technique utilized in evaluating a patient~litigant and to be more conversant with the role of an expert witness with respect to allegations of hearing loss.
With increasing frequency, otologists are called on to render expert opinions regarding the auditory status of litigants. Such opinions must be based on a thorough examination of all the pertinent facts and rely heavily on the audiometric data. Whereas patients generally seek relief from pain and suffering or improvement of their hearing, in litigation the patient/litigant may seek recovery in a monetary form, the magnitude of which may depend on the clinical history offered and responses on audiometric testing. It is the ability of the expert to evaluate the efficacy of both the audiologic results and the assessment procedure itself that is crucial to the formulation of a carefully considered opinion. The course will draw on two decades of clinical experience in evaluating hearing loss litigants and their claims. The course has a twofold purpose: (1) to raise to the consciousness the potential for hidden exaggeration on the part of litigants and (2) to review a variety of procedures that should be considered to accurately assess these patients and to identify or rule out functional components. Relevant examples will be drawn from patient/litigant experiences. This course should prove to be of equal value to both the examining clinician and the reviewing expert. Topics to be covered include exaggeration: a realistic view; an index of suspicion: the concept; possible indications of exaggeration found during patient assessment; classic audiologic findings suggestive of exaggeration; the use of special tests; recommended procedures to expedite the identification of exaggeration; the clinical resolution of discrepancies; recommendations for preparing reports and testimony; and the role of the expert witness.