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New phonosurgical procedures: Medialization thyroplasty
Otolaryngology Head and Neck Surgery Volume 112 Number 5
COURSE 3633-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-96 1:45-2:45
Otologic Photography: Indications and Technique C. BRUCEMACDONALD,MD Boston, Mass.
Educational objectives: To understand the benefits of photodocumentation of otologic disease with respect to patient counseling, informed consent, billing, long-term patient follow-up, and primary care physician and resident education.
Photographing the ear has become popular with otologists, and recently with audiologists. However, although commercial equipment for still and video photography has become readily available, many otolaryngologists have not taken advantage of the technology. Often those who have invested in equipment are disappointed in the quality of their photographs. This course demonstrates the utility and technique of otologic photography in modem practice. Indications for photographic documentation include longterm nonoperative care of middle ear disease. For example, atelectasis or small epitympanic disease can be precisely monitored for signs of progression. Patient education and satisfaction are enhanced if they view their own ear, rather than diagrams or rough drawings. Referring physicians and insurance personnel can readily understand the consultation and recommendations if photos are included. Photographs provide objective evidence of disease when billing disputes or medical-legal issues are a concern. Equipment and appropriate techniques for still and video photography in the office and operating room are reviewed. Compatibility of components, light sources, film, videotape recorders, cameras, and practical points will be stressed. Inexpensive modification of systems for laryngeal or sinus examination to obtain excellent otologic photographs will be reviewed. Common pitfalls resulting in suboptimal images, and ways to fine-tune technique will be discussed.
COURSE 3634-1 One-period course ($20)
Room NOCC-97 1:45-2:45
Surgical Management of the External Auditory Canal SIMON C. PARISlER,MD New York, N.Y.
Educational objectives: To understand the applied anatomy of the ear canal and to develop an operative technique useful for the surgical management of the ear canal in a variety of conditions.
Experience with a large otologic referral practice indicates that a narrowed or stenotic ear canal is a frequent
P 133
cause of failure for what might have been an otherwise successful ear operation. This course reviews the principles and techniques necessary to successfully manage the external ear canal surgically. A stepwise description of my surgical approach with illustrations, photographs and videotapes will be presented. The use of this approach for tympanomastoidectomy, osteoma, exostoses, acquired stenosis, and congenital atresia will be illustrated.
COURSE 3635-1 One-period course ($20)
Room NOCC-98 1:45-2:45
New Phonosurgical Procedures: Medialization Thyroplasty CHARLESW. CUMMINGS, MD, and PAULW. FLINT,MD Baltimore, Md.
Educational objectives: To identify and evaluate candidates for medialization thyroplasty and to apply the techniques of this procedure while avoiding pitfalls and complications.
Laryngeal implantation for medialization (type I thyroplasty) has improved our ability to manage patients with vocal fold motion impairment. This procedure offers the following advantages: (1) it is performed with local anesthesia and minimal or no discomfort to the patient; (2) patient positioning is more anatomic, allowing better assessment of voice during the procedure; (3) it is potentially reversible; and (4) because the prothesis is placed lateral to the inner perichondrium of the thyroid lamina, structural integrity of the vocal fold is preserved. Disadvantages include: (1) the patient is subjected to an open procedure, (2) the procedure is technically more difficult, and (3) potential complications may result in pestoperative dysphonia and possible implant displacement or extrusion. This course will address the management of patients with vocal fold motion impairment, vocal fold bowing, and soft tissue deficits in which medialization thyroplasty is applicable. Indications and timing of intervention, patient evaluation, and surgical techniques will be addressed. Through a series of case presentations, the various applications for medialization thyroplasty will be reviewed. Difficult cases will be discussed with special emphasis on avoidance of pitfalls and complications.
COURSE 3633-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-96 1:45-2:45
Otologic Photography: Indications and Technique C. BRUCEMACDONALD,MD Boston, Mass.
Educational objectives: To understand the benefits of photodocumentation of otologic disease with respect to patient counseling, informed consent, billing, long-term patient follow-up, and primary care physician and resident education.
Photographing the ear has become popular with otologists, and recently with audiologists. However, although commercial equipment for still and video photography has become readily available, many otolaryngologists have not taken advantage of the technology. Often those who have invested in equipment are disappointed in the quality of their photographs. This course demonstrates the utility and technique of otologic photography in modem practice. Indications for photographic documentation include longterm nonoperative care of middle ear disease. For example, atelectasis or small epitympanic disease can be precisely monitored for signs of progression. Patient education and satisfaction are enhanced if they view their own ear, rather than diagrams or rough drawings. Referring physicians and insurance personnel can readily understand the consultation and recommendations if photos are included. Photographs provide objective evidence of disease when billing disputes or medical-legal issues are a concern. Equipment and appropriate techniques for still and video photography in the office and operating room are reviewed. Compatibility of components, light sources, film, videotape recorders, cameras, and practical points will be stressed. Inexpensive modification of systems for laryngeal or sinus examination to obtain excellent otologic photographs will be reviewed. Common pitfalls resulting in suboptimal images, and ways to fine-tune technique will be discussed.
COURSE 3634-1 One-period course ($20)
Room NOCC-97 1:45-2:45
Surgical Management of the External Auditory Canal SIMON C. PARISlER,MD New York, N.Y.
Educational objectives: To understand the applied anatomy of the ear canal and to develop an operative technique useful for the surgical management of the ear canal in a variety of conditions.
Experience with a large otologic referral practice indicates that a narrowed or stenotic ear canal is a frequent
P 133
cause of failure for what might have been an otherwise successful ear operation. This course reviews the principles and techniques necessary to successfully manage the external ear canal surgically. A stepwise description of my surgical approach with illustrations, photographs and videotapes will be presented. The use of this approach for tympanomastoidectomy, osteoma, exostoses, acquired stenosis, and congenital atresia will be illustrated.
COURSE 3635-1 One-period course ($20)
Room NOCC-98 1:45-2:45
New Phonosurgical Procedures: Medialization Thyroplasty CHARLESW. CUMMINGS, MD, and PAULW. FLINT,MD Baltimore, Md.
Educational objectives: To identify and evaluate candidates for medialization thyroplasty and to apply the techniques of this procedure while avoiding pitfalls and complications.
Laryngeal implantation for medialization (type I thyroplasty) has improved our ability to manage patients with vocal fold motion impairment. This procedure offers the following advantages: (1) it is performed with local anesthesia and minimal or no discomfort to the patient; (2) patient positioning is more anatomic, allowing better assessment of voice during the procedure; (3) it is potentially reversible; and (4) because the prothesis is placed lateral to the inner perichondrium of the thyroid lamina, structural integrity of the vocal fold is preserved. Disadvantages include: (1) the patient is subjected to an open procedure, (2) the procedure is technically more difficult, and (3) potential complications may result in pestoperative dysphonia and possible implant displacement or extrusion. This course will address the management of patients with vocal fold motion impairment, vocal fold bowing, and soft tissue deficits in which medialization thyroplasty is applicable. Indications and timing of intervention, patient evaluation, and surgical techniques will be addressed. Through a series of case presentations, the various applications for medialization thyroplasty will be reviewed. Difficult cases will be discussed with special emphasis on avoidance of pitfalls and complications.