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Management of incus problems
Ototaryngology Head and Neck Surgery Volume 112 Number 5
COURSE 1732- I One-period course ($20)
Instruction Courses -- Sunday
Room NOCC-95 3:00~4:00
COURSE 1734-I One-period course ($20)
Videostrobolaryngoscopy: Dynamic Laryngopathology
Myringoplasty as an Office Procedure
C. RICHARD STASNEY,MD, J. DAVID GARREI"i',PhD, and SHARON L. RADIONOFF, MD Houston, Texas
EDGAR CHIOSSONE, MD Caracas, Venezuela
Educational objectives: To appreciate more fully the applications of videostrobolaryngoscopy and to see various examples of pathologic conditions and hear suggestions for medical and surgical treatment of each lesion.
Through the use of videostrobolaryngoscopy we intend to demonstrate to the participants approximately 25 examples of laryngopathology. We will go over each case and discuss our suggestions for appropriate medical and surgical treatment. Included examples will be: laryngitis sicca, vocal polyps (angiomatous, fibrous, cystic), vocal cord cyst, vocal cord sulcus, scarring, reflux laryngitis, and other benign lesions. Neurological lesions will include superior and recurrent nerve paralyses and adductor and abductor spasmodic dysphonia. Also included will be the medical and surgical treatment of these lesions: phonosurgery, thyroplasties, and botulinum toxin injections.
COURSE 1733-I One-period course ($20)
Room NOCC-96 3:013-4:00
Management of Incus Problems EDWARD L. APPLEBAUM,MD C h i c a g o , III.
Educational objectives: To recognize the various incus defects and to recall effective surgical management techniques to repair incus defects.
Defects of the incus are common sequelae of chronic otitis media and trauma. These defects range from minute erosions of the lenticular process to complete absence of a usable incus. If the incus problem can be seen through a transparent tympanic membrane or a perforation, or if it is large enough to be visualized on CT scan, then diagnosis and preoperative planning are not problematic. At times, however, incus problems are diagnosed only at surgery, so ear surgeons must be prepared to manage them effectively whenever tympanoplasty is attempted. This course presents the author's methods of managing the most common incus problems. A systematic, simple, and predictable approach uses two prostheses designed by the author and readily available. The incudostapedial joint prosthesis is used for defects of the long process, and the incus replacement system is used when there is no useful incus remaining. Both prostheses are made of hydroxyapatite. By means of slides and surgical videos, the indications and techniques of tympanoplasty for these implants will be discussed.
P 55
Room NOCC-97 3:00-4:00
Educational objectives: To select cases properly, to avoid complications, and to improve surgical skill.
Central tyt'apanic membrane perforations as sequelae of an aggressive middle ear infection or traumatism are frequent pathologic conditions observed in dally otologic practice. Although in many cases there is a normal dry middle ear, the perforation predisposes to frequent recurrent middle ear infections that cause annoying disturbances to the patient and a mild-to-moderate hearing loss. The surgical treatment of choice in this case is a myringoplasty, which usually is performed with the patient under general anesthesia through a retroauricular incision with at least 24 hours of hospital stay. We have developed a simplified surgical technique that can be safely performed in the doctor' s office as an outpatient procedure. Good case selection, very specific indications, minimal surgical setup in the office, and surgical skill in transcanal surgery are the keys for a high success rate and avoidance of complications. This instruction course discusses in detail the advantages and disadvantages of this surgical technique, the preoperative selection of patients, the indications and contraindications, the surgical setup, the surgical technique, and the postoperative results in over 200 consecutive cases.
COURSE 1735- I One-period course ($20)
Room N0CC-98 3:00-4:00
Mastoidectomy forthe General Otolaryngologist REX S. HABERMAN, II, MD
St. Paul, Minn.
Educational objectives: To comfortably perform a complete mastoidectomy including intact CW procedures with facial recess and CWD procedures and to utilize specific tips to be able to consistently identify critical mastoid landmarks.
For the practicing otologlst, mastoidectomy is frequently performed. For the practicing general otolaryngologists, mastoidectomy may only be performed a few times per year. In dealing with cholesteatoma and chronic otitis media, a complete mastoidectomy (including wide exposure of the facial recess) must be done to avoid leaving residual disease behind. Based on over 450 mastoid operations over the last 4 years, the instructor has identified many subtle fine points which make the surgery easier. Specifically, emphasis is placed on the following: (1) patient prepping and positioning, (2) surgeon positioning, (3) correct microscope magnification, (4) appropriate burr size, (5) when to use a diamond burr, (6) how to make suction-irrigation a critical ally, (7) how to easily incorporate photodocu-
COURSE 1732- I One-period course ($20)
Instruction Courses -- Sunday
Room NOCC-95 3:00~4:00
COURSE 1734-I One-period course ($20)
Videostrobolaryngoscopy: Dynamic Laryngopathology
Myringoplasty as an Office Procedure
C. RICHARD STASNEY,MD, J. DAVID GARREI"i',PhD, and SHARON L. RADIONOFF, MD Houston, Texas
EDGAR CHIOSSONE, MD Caracas, Venezuela
Educational objectives: To appreciate more fully the applications of videostrobolaryngoscopy and to see various examples of pathologic conditions and hear suggestions for medical and surgical treatment of each lesion.
Through the use of videostrobolaryngoscopy we intend to demonstrate to the participants approximately 25 examples of laryngopathology. We will go over each case and discuss our suggestions for appropriate medical and surgical treatment. Included examples will be: laryngitis sicca, vocal polyps (angiomatous, fibrous, cystic), vocal cord cyst, vocal cord sulcus, scarring, reflux laryngitis, and other benign lesions. Neurological lesions will include superior and recurrent nerve paralyses and adductor and abductor spasmodic dysphonia. Also included will be the medical and surgical treatment of these lesions: phonosurgery, thyroplasties, and botulinum toxin injections.
COURSE 1733-I One-period course ($20)
Room NOCC-96 3:013-4:00
Management of Incus Problems EDWARD L. APPLEBAUM,MD C h i c a g o , III.
Educational objectives: To recognize the various incus defects and to recall effective surgical management techniques to repair incus defects.
Defects of the incus are common sequelae of chronic otitis media and trauma. These defects range from minute erosions of the lenticular process to complete absence of a usable incus. If the incus problem can be seen through a transparent tympanic membrane or a perforation, or if it is large enough to be visualized on CT scan, then diagnosis and preoperative planning are not problematic. At times, however, incus problems are diagnosed only at surgery, so ear surgeons must be prepared to manage them effectively whenever tympanoplasty is attempted. This course presents the author's methods of managing the most common incus problems. A systematic, simple, and predictable approach uses two prostheses designed by the author and readily available. The incudostapedial joint prosthesis is used for defects of the long process, and the incus replacement system is used when there is no useful incus remaining. Both prostheses are made of hydroxyapatite. By means of slides and surgical videos, the indications and techniques of tympanoplasty for these implants will be discussed.
P 55
Room NOCC-97 3:00-4:00
Educational objectives: To select cases properly, to avoid complications, and to improve surgical skill.
Central tyt'apanic membrane perforations as sequelae of an aggressive middle ear infection or traumatism are frequent pathologic conditions observed in dally otologic practice. Although in many cases there is a normal dry middle ear, the perforation predisposes to frequent recurrent middle ear infections that cause annoying disturbances to the patient and a mild-to-moderate hearing loss. The surgical treatment of choice in this case is a myringoplasty, which usually is performed with the patient under general anesthesia through a retroauricular incision with at least 24 hours of hospital stay. We have developed a simplified surgical technique that can be safely performed in the doctor' s office as an outpatient procedure. Good case selection, very specific indications, minimal surgical setup in the office, and surgical skill in transcanal surgery are the keys for a high success rate and avoidance of complications. This instruction course discusses in detail the advantages and disadvantages of this surgical technique, the preoperative selection of patients, the indications and contraindications, the surgical setup, the surgical technique, and the postoperative results in over 200 consecutive cases.
COURSE 1735- I One-period course ($20)
Room N0CC-98 3:00-4:00
Mastoidectomy forthe General Otolaryngologist REX S. HABERMAN, II, MD
St. Paul, Minn.
Educational objectives: To comfortably perform a complete mastoidectomy including intact CW procedures with facial recess and CWD procedures and to utilize specific tips to be able to consistently identify critical mastoid landmarks.
For the practicing otologlst, mastoidectomy is frequently performed. For the practicing general otolaryngologists, mastoidectomy may only be performed a few times per year. In dealing with cholesteatoma and chronic otitis media, a complete mastoidectomy (including wide exposure of the facial recess) must be done to avoid leaving residual disease behind. Based on over 450 mastoid operations over the last 4 years, the instructor has identified many subtle fine points which make the surgery easier. Specifically, emphasis is placed on the following: (1) patient prepping and positioning, (2) surgeon positioning, (3) correct microscope magnification, (4) appropriate burr size, (5) when to use a diamond burr, (6) how to make suction-irrigation a critical ally, (7) how to easily incorporate photodocu-