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Improved treatment of malar complex fracture
P44
Otolaryngology Head and Neck Surgery
InstructionCourses--Sunday
May 1995
pital, which has over a decade of experience with cochlear implants. The course will present information in the following areas: I. Selection--The use of the CHIP (Children's Implant Profile) will be presented to illustrate its utility through the selection and habilitative process. 2. Surgery--Complications and reimplantation issues that have been encountered will be discussed through case presentations. 3. Cochlear implant tuning--Methods of device, tuning both behavioral and electophysiologic, will be presented. 4. Educational programming--The role of the educational consultant and its impact on the child's performance will be emphasized. 5. Results--Perceptual and productive changes after implant will be reviewed.
COURSE 1633- I
One-period course ($20)
Room NOCC-96 1:45-2:45
Alternative Surgeries for Vertigo in Meniere's Disease DIRK HOEHMANN, MD, PhD, and JOHN L. DORNHOFFER,MD
WQrzburg, Germany, and Little Rock, Ark.
Educational objectives: To find a straightforward strategy in dealing with vertigo in patients with Meniere's disease who failed medical treatment, and to be familiar with fine points of surgical procedures, including endolymphatic sac surgery, cochleostomy, vestibular nerve sections, and labyrinthectomy.
Surgery for Meniere's disease is performed if 3 to 6 months of adequate medical treatment has been tried and symptoms recur despite the patient's compliance. Currently, there are many types of surgery for Meniere's disease. The major destructive and nondestructive procedures on the inner ear are covered. The discussion will focus on clinical decisions, types of Meniere's disease, clinical stages, electrocochleography (ECoG) findings, and technical aspects of each surgery discussed. A first part will cover the various nondestructive surgeries performed at both the distal and the proximal endolymphatic system, including the various types of shunting procedures and other nondestructive procedures performed at alternative points of entry into the membranous labyrinth. The role of intraoperative ECoG monitoring in all of these surgeries will be discussed. Destructive procedures, including labyrinthectomy and selective vestibular nerve sections from various approaches, will be discussed. The fine points of the technical aspects of the major procedures will be demonstrated by slides and videotapes.
COURSE 1634- I
One-period course ($20)
Room NOCC-97 1:45-2:45
Improved Treatment of Malar Complex Fracture ROWAN S. MATSUNAGA,MD, PAUL H. TOFFEL,MD, and WILLIAM SIMPSON, MD
Beverly Hills, Inglewood, and Los Angeles, Calif.
Educational objectives: To learn a new technique to repair a depressed malar fracture, which can give improved results by stable fixation and no visible scars o f the periorbital areas, and to save about 50% of operating time.
About 25% of malar complex fracture reduction procedures using the usual interosseous wire fixation method produce a postoperative facial disfigurement by leaving a depressed cheek bone and facial asymmetry. Furthermore, prominent incisional scars of the eyelid area have resulted occasionally by this procedure or by the plating procedures. A simplified and new approach to malar complex fracture management has been developed; it eliminates the residual facial deformity and prominent scars, and reduces the operating time by more than 50%. This improved surgical procedure originated in the senior author's private practice and at the Los Angeles County General Hospital-University of Southern California Medical Center. The method makes use of a Gillies' incision, and the depressed malar fracture is reduced in the usual manner with a stout elevator. The fixation of the reduced malar bone is accomplished by use of an internal pin fixation tailored to the mechanical requirements of the malar fracture forces. The pin is left buried subcutaneously for six weeks and is removed in the office under local anesthesia. No scar is made on the lower eyelid or brow as is done for the usual interosseous wire fixation or plating methods. In severe facial injuries, this method may be the only treatment for stabilizing a malar fracture when adjacent bones a r e also fractured and unstable.
COURSE 1635-1
One-period course ($20)
Room NOCC-98 1:45-2:45
Medial Graft fympanoplasty Using Williams Microclips DUDLEY J. WEIDER,MD
Lebanon, N.H.
Educational objectives: To perform a tympanoplasty with a success rate in the high 90s, to make Williams microclips for own use, and to have the confidence to perform successful tympanoplasry on atelectatis ears.
This is a medial graft technique utilizing fresh, "undried" temporalis fascia or tragal perichondrium beneath a specially prepared tympanic membrane remnant. The graft is usually, although not always, supported with Gel Foam and then secured to the prepared remnant with three microclips made from 34-gauge stainless steel wire. The technique has been used by the author since 1971 in over 2000 cases
Otolaryngology Head and Neck Surgery
InstructionCourses--Sunday
May 1995
pital, which has over a decade of experience with cochlear implants. The course will present information in the following areas: I. Selection--The use of the CHIP (Children's Implant Profile) will be presented to illustrate its utility through the selection and habilitative process. 2. Surgery--Complications and reimplantation issues that have been encountered will be discussed through case presentations. 3. Cochlear implant tuning--Methods of device, tuning both behavioral and electophysiologic, will be presented. 4. Educational programming--The role of the educational consultant and its impact on the child's performance will be emphasized. 5. Results--Perceptual and productive changes after implant will be reviewed.
COURSE 1633- I
One-period course ($20)
Room NOCC-96 1:45-2:45
Alternative Surgeries for Vertigo in Meniere's Disease DIRK HOEHMANN, MD, PhD, and JOHN L. DORNHOFFER,MD
WQrzburg, Germany, and Little Rock, Ark.
Educational objectives: To find a straightforward strategy in dealing with vertigo in patients with Meniere's disease who failed medical treatment, and to be familiar with fine points of surgical procedures, including endolymphatic sac surgery, cochleostomy, vestibular nerve sections, and labyrinthectomy.
Surgery for Meniere's disease is performed if 3 to 6 months of adequate medical treatment has been tried and symptoms recur despite the patient's compliance. Currently, there are many types of surgery for Meniere's disease. The major destructive and nondestructive procedures on the inner ear are covered. The discussion will focus on clinical decisions, types of Meniere's disease, clinical stages, electrocochleography (ECoG) findings, and technical aspects of each surgery discussed. A first part will cover the various nondestructive surgeries performed at both the distal and the proximal endolymphatic system, including the various types of shunting procedures and other nondestructive procedures performed at alternative points of entry into the membranous labyrinth. The role of intraoperative ECoG monitoring in all of these surgeries will be discussed. Destructive procedures, including labyrinthectomy and selective vestibular nerve sections from various approaches, will be discussed. The fine points of the technical aspects of the major procedures will be demonstrated by slides and videotapes.
COURSE 1634- I
One-period course ($20)
Room NOCC-97 1:45-2:45
Improved Treatment of Malar Complex Fracture ROWAN S. MATSUNAGA,MD, PAUL H. TOFFEL,MD, and WILLIAM SIMPSON, MD
Beverly Hills, Inglewood, and Los Angeles, Calif.
Educational objectives: To learn a new technique to repair a depressed malar fracture, which can give improved results by stable fixation and no visible scars o f the periorbital areas, and to save about 50% of operating time.
About 25% of malar complex fracture reduction procedures using the usual interosseous wire fixation method produce a postoperative facial disfigurement by leaving a depressed cheek bone and facial asymmetry. Furthermore, prominent incisional scars of the eyelid area have resulted occasionally by this procedure or by the plating procedures. A simplified and new approach to malar complex fracture management has been developed; it eliminates the residual facial deformity and prominent scars, and reduces the operating time by more than 50%. This improved surgical procedure originated in the senior author's private practice and at the Los Angeles County General Hospital-University of Southern California Medical Center. The method makes use of a Gillies' incision, and the depressed malar fracture is reduced in the usual manner with a stout elevator. The fixation of the reduced malar bone is accomplished by use of an internal pin fixation tailored to the mechanical requirements of the malar fracture forces. The pin is left buried subcutaneously for six weeks and is removed in the office under local anesthesia. No scar is made on the lower eyelid or brow as is done for the usual interosseous wire fixation or plating methods. In severe facial injuries, this method may be the only treatment for stabilizing a malar fracture when adjacent bones a r e also fractured and unstable.
COURSE 1635-1
One-period course ($20)
Room NOCC-98 1:45-2:45
Medial Graft fympanoplasty Using Williams Microclips DUDLEY J. WEIDER,MD
Lebanon, N.H.
Educational objectives: To perform a tympanoplasty with a success rate in the high 90s, to make Williams microclips for own use, and to have the confidence to perform successful tympanoplasry on atelectatis ears.
This is a medial graft technique utilizing fresh, "undried" temporalis fascia or tragal perichondrium beneath a specially prepared tympanic membrane remnant. The graft is usually, although not always, supported with Gel Foam and then secured to the prepared remnant with three microclips made from 34-gauge stainless steel wire. The technique has been used by the author since 1971 in over 2000 cases