Temporal Bone - Otology

Cochlear Implant Play video

Clinical Cases
Video No
08
3D
Duration
60min

Indications:

  • Case 1: Congenital bilateral total deafness
  • Case 2: Bilateral deafness after open Mastoidectomy
  • Case 3: bilateral deafness after transmastoid extracochlear Implant

Highlights

  1. L-shaped retroauricular incision for skin flaps
  2. Inverted L-shaped incision for musculoperiosteal flap
  3. Bed for the receiver/stimulator package
  4. Partial anterior mastoidectomy
  5. Retrograde exposure of mastoid segment of fallopian canal
  6. Posterior tympanotomy with exposure of round window niche
  7. Formation of mastoid groove for the electrode lead
  8. Placement of receiver/stimulation package in its bony bed and fixation under parietosquamous periosteal pouch
  9. Introduction of electrode array into basal turn of the cochlea
  10. Placement of electrode lead in its bony groove
  11. Wound closure in layers

Surgery of the External Auditory Canal Play video

Clinical Cases
Video No
07
3D
Duration
60min

Indications

  • Case 1: Meatoplasty for narrow EAC
  • Case 2: Meatoplasty in closed cavity
  • Case 3: Meatoplasty in open cavity
  • Case 4. Blind sac closure of EAC
  • Case 5. Canalplasty for Exostosis
  • Case 6. Canalplasty for Otitis externa stenosans

Highlights

MEATOPLASTY (Case 1-4)

  1. Endaural/retroauricular skin incision
  2. Removal of excess conchal cartilage
  3. Removal of excess bony canal
  4. Elevation and rotation of skin flaps
  5. Packing of enlarged meatus

CANALPLASTY (Case 5-6)

  1. Endaural incision
  2. Elevation of meatal skin flaps
  3. Canalplasty
  4. Removal of exostosis/obliterating tissue
  5. Exposure of new tympanic sulcus
  6. Reposition and fixation of meatal skin flaps
  7. Wound closure and packing

Open Mastoido-Epitympanectomy with Tympanoplasty (Type III) and posterior Obliteration Play video

Indication: Chronic otitis media with subtotal perforation and secondary acquired Cholesteatoma - Clinical Case (Left side)
Video No
06e
3D
Duration
73min

Highlights

  1. Canalplasty (retroauricular approach)
  2. Mastoidectomy
  3. Epitympanectomy
  4. Cholesteatoma removal
  5. Myringoplasty
  6. Posterior obliteration of open cavity with occipital myosubcutaneous flap
  7. Meatoplasty
  8. Wound closure and packing

 

 

Open Mastoido-Epitympanectomy with Tympanoplasty (Type III) Play video

Indication: secondary acquired Cholesteatoma after open cavity performed elsewhere with postoperative facial palsy and chronic ear secretion since many years. Clinical Case (Left side)
Video No
06d
3D
Duration
60min

Highlights

  1. Mastoidectomy (retroauricular approach)
  2. Epitympanectomy
  3. Canalplasty
  4. Cholesteatoma removal (middle ear)
  5. Cholesteatoma removal (epitympanum)
  6. Epitympanectomy (radical exenteration and exteriorization of supratubal and supralabyrinthine recess
  7. Myringoplasty
  8. Anterior packing of open cavity
  9. Posterior obliteration of open cavity with occipital myosubcutaneous flap
  10. Meatoplasty
  11. Wound closure and packing

 

 

Open Mastoido-Epitympanectomy with Tympanoplasty (first stage) Play video

Removal of a secondery acquired attic Cholesteatoma and partial Obliteration Clinical Case (Left side)
Video No
06c
3D
Duration
31min

Highlights

  1. Retroauricular skin incision
  2. Meatal skin flap
  3. Exploration of Middle Ear (Cholesteatoma)
  4. Canalplasty
  5. Antrotomy
  6. Mastoidectomy
  7. Epitympanectomy with removal of Cholesteatoma and identification of tympanic segment of facial nerve
  8. Extended canalplasty
  9. Myringoplasty
  10. Posterior obliteration of open cavity with occipital myosubcutaneous flap
  11. Meatoplasty
  12. Wound closure and packing

Open Mastoido-Epitympanectomy with Tympanoplasty Type III Play video

Clinical Case (secondary acquired attic cholesteatoma) (Right side)
Video No
06b
3D
Duration
86min

Highlights

  1. Retroauricular skin incision
  2. Meatal skin flap
  3. Canalplasty
  4. Wide removal of bone over middle cranial fossa dura, sigmoid sinus and sinus dura angle
  5. Exposure of digastric muscle
  6. Epitympanotomy with identification of tympanic segment of facial nerve
  7. Lowering facial ridge over mastoid segment of fallopian canal
  8. Radical exenteration and exposure of retrofacial and retrolabyrinthine cells
  9. Radical exenteration and exposure of supralabyrinthine and supratubal recesses (epitympanectomy)
  10. Extended canalplasty with removal of antero-inferior overhang of tympanic bone
  11. Radical removal of matrix from tympanic cavity
  12. Formation of a new tympanic sulcus
  13. Removal of mastoid tip
  14. Tympanoplasty (Type III)
  15. Obliteration of posterior cavity with occipital myosubcutaneous flap
  16. Meatoplasty
  17. Reposition of meatal skin flap and packing
  18. Wound closure and packing

Open Mastoido-Epitympanectomy Play video

Temp. Bone Dissection (Right side)
Video No
06a
3D
Duration
56min

Part 1: Mastoidectomy, Epitympanectomy  41 min
Part 2: Tympanoplasty (first stage)  13 min

Highlights

  1. Retroauricular approach
  2. Meatal skin flap (alternative technique)
  3. Canalplasty
  4. Wide removal of bone over middle cranial fossa dura, sigmoid sinus and sinus dura angle
  5. Exposure of digastric muscle
  6. Epitympanotomy with identification of tympanic segment of facial nerve
  7. Lowering facial ridge over mastoid segment of fallopian canal
  8. Radical exenteration and exposure of retrofacial and retrolabyrinthine cells
  9. Radical exenteration and exposure of supralabyrinthine and supratubal recesses (epitympanectomy)
  10. Extended canalplasty with removal of antero-inferior overhang of tympanic bone
  11. Radical removal of matrix from tympanic cavity
  12. Formation of a new tympanic sulcus
  13. Removal of mastoid tip
  14. Tympanoplasty (first stage)
  15. Obliteration of posterior cavity with occipital myosubcutaneous flap
  16. Meatoplasty
  17. Reposition of meatal skin flap and packing

Malleo-Stapedotomy Play video

Anatom. Dissection and Clin. Cases Endaural Approach (Right Side)
Video No
05b
3D
Duration
53min

Highlights

  1. Endaural incision
  2. Meatal skin flap with anterior extension
  3. Anterosuperior canalplasty
  4. Exposure of ant. tymp. Spine and ant. mallear proc. and lig. for assessment of malleus mobility
  5. Removal of incus
  6. Drilling away ossified ant. mallear lig. and removal of malleus head
  7. Introduction of Titanium Stapes Prosthesis (straight or angled) between malleus handle and stapes footplate
  8. Stapedotomy with manual perforators
  9. Removal of stapes arch with crurotomy scissors
  10. Introduction of stapes piston into vestibule
  11. Crimping of titanium loop to malleus handle and sealing of stapedotomy opening
  12. Packing and wound closure

Incudo-Stapedotomy Play video

Amatom. Dissection and Clin. Cas Endaural Approach
Video No
05a
3D
Duration
79min

Highlights

  1. Endaural skin incision
  2. Meatal skin flap with ant. extension
  3. Anterosuperior  canalplasty for evaluation of mobility of malleus and incus
  4. Exposure of oval window
  5. Evaluation of stapes mobility
  6. Trimming of stapes prosthesis
  7. Stapedotomy with manual perforators
  8. Introduction and crimping of stapes prosthesis
  9. Removal of stapes arch
  10. Sealing of stapedotomy opening
  11. Packing and wound closure

Revision tympano mastoidectomy with grafting of iatrogenic lesion of the facial nerve Play video

Clinical case (right side)
Video No
04
3D
Duration
48min

Highlights:

  1. Information with preop. Radiology (5 min)
  2. Retroauricular skin incision (1 min)
  3. Revision mastoidectomy (4 min)
  4. Revision Canalplasty (5 min)
  5. Ossiculoplasty: inspection of the ossicular chain (2 min)
  6. Antrotomy (1 min)
  7. Epitympanotomy (1 min)
  8. Ossiculoplasty: lateralization of the malleus (3 min)
  9. Myringoplasty: water test (1 min)
  10. Mastoidectomy (5 min): 10a retrograde exposure of FN and identification of nerve injury (4 min), 10b exposure of tympanic segment of FN (1 min)
  11. Drilling of new Fallopian canal for grafting (1 min)
  12. Elevation of distal stump of the FN (1 min)
  13. Reconstruction of bony posterior canal with bone flap from the temporal squama (3 min)
  14. Harvesting and preparation of nerve graft (greater auricular nerve) (3 min)
  15. Introduction and coaptation of reverse nerve graft (4 min)
  16. Myringoplasty with temporalis fascia (3 min)
  17. Wound closure and postoperative results (1 min)