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Intratympanic gentamicin for meniere's disease
P176
Otolaryngology Head and Neck Surgery
Instruction Courses-- Wednesday
May 1995
Revision stapedectomy A. Assessing cases to revise 1. Operative n o t e 2. Type of prosthesis 3. Experience of previous surgeon 4. Postoperative hearing patterns B. Surgical findings and techniques for the "Wive" prosthesis 1. Prosthesis malfunction 2. Incus erosion 3. Negative findings 4. Perilymphatic fistulas 5. Dizziness C. Surgical findings and techniques for "piston on tissue" prosthesis 1. Prosthesis malfunction 2. Incus erosion 3. Perilymphatic fistulas 4. Negative findings 5. Miscellaneous findings D. Surgical techniques 1. Removing prosthesis 2. Locating the patent oval window 3. Techniques for the dizzy patient 4. Reconstructing the ossicular chain E. Guidelines 1. Should revise, or only explore? 2. Avoiding heating trauma 3. Recognizing hearing patterns
COURSE46 18-1 One-period course ($20)
Room NOCC-80 2:30-3:30
Management of Subglottic Stenosis MARSHALLSTROME, MD, MS Cleveland, Ohio
Educational objectives: To integrate an endoscopic classification with specific therapeutic moralities and to have a complete understanding o f the AP split--indications, procedure, and postoperative management.
Subglotfic stenosis can be treated appropriately only if there is an integrated understanding of the functional stage of the pathologic evolution, its diagnosis, and a therapeutic regimen specific to the degree of histopathologic injury. Endoscopic staging correlates well with histopathologic change. It will be discussed in detail, and this functional data correlated with the varied techniques available
for therapeusis: endoscopic, to include laser, cryosurgery, and electrodesiccation; open, with particular attention given to anteroposterior splitting of the cricoid for the most severe cases. Ancillary techniques will be put in proper perspective; medical to include antibiotics and steroids, further defining inhalation, local injection, and systemic administration. Surgically, preparation of appropriate-size stents is elucidated, and the considerations necessitating their usage is outlined. Resurfacing with split-thickness skin, buccal mucosa, perichondrium, etc., will be considered. Similarly, the use of bone, cartilage, muscle, and vascularized bone grafts will be discussed regarding their relative merits for bridging the space created by an anterior cricoid split and laryngofissure. The appropriate time for stent removal, the implications of the endoscopic appearance at stent removal, the management of stent granulomas, the appropriateness of extubation at the time of the fn'st stent removal, and the closure of tracheocutaneous fistulas will be placed in proper prospective.
COURSE 4620- I One-period course ($20)
Room NOCC-82 2:30-3:30
Intratympanic Gentamicin for Meniere's Disease LOREN J. BARTELS,MD, and JONATHON $. S|LLMAN,MD Tampa, Fla.
Educational objectives: To comprehensively evaluate patients with Meniere' s disease and determine their candidacy f o r gentamicin therapy and to administer intratympanic gentamicin f o r the treatment o f vertico in Meniere's disease.
Intratympanic gentamicin is being used more commonly for the treatment of vertigo in patients with Meniere's disease. Its efficacy has been demonstrated, but an optimal treatment regimen with low risk of deafness has yet to be determined. This course will review the history of aminoglycoside use for the treatment of Meniere's disease. The various treatment regimens that have been used recently will be reviewed, with discussion of the advantages and disadvantages of each method. The senior author's regimen will be described, and the results of a series of 38 patients treated, with up to 2-year follow-up, will be presented. The potential causes of treatment failure will be discussed, as well as the management of recurrent vertigo after initial control with intratympanic gentamicin therapy. Ideas for further refinement of this technique will be discussed.
Otolaryngology Head and Neck Surgery
Instruction Courses-- Wednesday
May 1995
Revision stapedectomy A. Assessing cases to revise 1. Operative n o t e 2. Type of prosthesis 3. Experience of previous surgeon 4. Postoperative hearing patterns B. Surgical findings and techniques for the "Wive" prosthesis 1. Prosthesis malfunction 2. Incus erosion 3. Negative findings 4. Perilymphatic fistulas 5. Dizziness C. Surgical findings and techniques for "piston on tissue" prosthesis 1. Prosthesis malfunction 2. Incus erosion 3. Perilymphatic fistulas 4. Negative findings 5. Miscellaneous findings D. Surgical techniques 1. Removing prosthesis 2. Locating the patent oval window 3. Techniques for the dizzy patient 4. Reconstructing the ossicular chain E. Guidelines 1. Should revise, or only explore? 2. Avoiding heating trauma 3. Recognizing hearing patterns
COURSE46 18-1 One-period course ($20)
Room NOCC-80 2:30-3:30
Management of Subglottic Stenosis MARSHALLSTROME, MD, MS Cleveland, Ohio
Educational objectives: To integrate an endoscopic classification with specific therapeutic moralities and to have a complete understanding o f the AP split--indications, procedure, and postoperative management.
Subglotfic stenosis can be treated appropriately only if there is an integrated understanding of the functional stage of the pathologic evolution, its diagnosis, and a therapeutic regimen specific to the degree of histopathologic injury. Endoscopic staging correlates well with histopathologic change. It will be discussed in detail, and this functional data correlated with the varied techniques available
for therapeusis: endoscopic, to include laser, cryosurgery, and electrodesiccation; open, with particular attention given to anteroposterior splitting of the cricoid for the most severe cases. Ancillary techniques will be put in proper perspective; medical to include antibiotics and steroids, further defining inhalation, local injection, and systemic administration. Surgically, preparation of appropriate-size stents is elucidated, and the considerations necessitating their usage is outlined. Resurfacing with split-thickness skin, buccal mucosa, perichondrium, etc., will be considered. Similarly, the use of bone, cartilage, muscle, and vascularized bone grafts will be discussed regarding their relative merits for bridging the space created by an anterior cricoid split and laryngofissure. The appropriate time for stent removal, the implications of the endoscopic appearance at stent removal, the management of stent granulomas, the appropriateness of extubation at the time of the fn'st stent removal, and the closure of tracheocutaneous fistulas will be placed in proper prospective.
COURSE 4620- I One-period course ($20)
Room NOCC-82 2:30-3:30
Intratympanic Gentamicin for Meniere's Disease LOREN J. BARTELS,MD, and JONATHON $. S|LLMAN,MD Tampa, Fla.
Educational objectives: To comprehensively evaluate patients with Meniere' s disease and determine their candidacy f o r gentamicin therapy and to administer intratympanic gentamicin f o r the treatment o f vertico in Meniere's disease.
Intratympanic gentamicin is being used more commonly for the treatment of vertigo in patients with Meniere's disease. Its efficacy has been demonstrated, but an optimal treatment regimen with low risk of deafness has yet to be determined. This course will review the history of aminoglycoside use for the treatment of Meniere's disease. The various treatment regimens that have been used recently will be reviewed, with discussion of the advantages and disadvantages of each method. The senior author's regimen will be described, and the results of a series of 38 patients treated, with up to 2-year follow-up, will be presented. The potential causes of treatment failure will be discussed, as well as the management of recurrent vertigo after initial control with intratympanic gentamicin therapy. Ideas for further refinement of this technique will be discussed.