
Part 1-2
Part 1: Combined transtemporal-transmastoid approach with meato-tympanic Rerouting and double grafting of theFacial Nerve after Longitudinal Fracture of the Temporal Bone (Right side 27 min)
Highlights:
- Introduction with Figures ( 5 min)
- Transmastoid Approach (4 min):
- exposure of mastoid, pyramidal and tympanic segments of the Facial Nerve (1 min)
- Identification of Facial Nerve lesion (3 min)
- Transtemporal (MCF) Approach (5 min):
- exposure of genu and labyrinthine segment of the Facial Nerve (4 min)
- meato-tympanic rerouting of Fallopian canal (1 min)
- Transmastoid approach (1 min): elevation of proximal stump of FN and enlargement of the Fallopian canal with the drill
- Transtemporal (MCF) Approach (4 min):
- decompression of lateral cistern of the posterior fossa (1 min)
- section of petrosal nerve distal to geniculum and of labyrinthine segment of the FN (1 min)
- Measurement, Harvesting and preparation of graft from the greater auricular nerve (2 min)
- Transmastoid Approach (1 min): introduction of double nerve graft
- Transtemporal (MCF) Approach (4 min):
- double grafting of proximal stump of the FN (3 min)
- wound closure with free muscle graft and craniotomy flap (1 min)
- Transmastoid approach: double grafting of distal stump of the FN (2 min)
- Combined Transtemporal-Transmastoid Approach final situation (1 min)
Part 2: Subtotal Petrosectomy with removal of the otic capsula , meato-cochleo-mastoid rerouting and grafting of the Facial Nerve after transverse fracture of the Temporal Bone (Right side 18 min)
Highlights:
- Introduction with figures (5 min)
- Mastoidectomy with exposure of fracture line from oval window to supralabyrinthine recess (2 min)
- Identification of traumatized tympanic segment of Facial Nerve (30 sec)
- Removal of otic capsula leaving the medial portion of the basal turn (1 min)
- Section of petrosal nerve and mobilization of the swollen labyrinthine segment of the Facial Nerve (1 min)
- Harvesting and preparation of the nerve graft (greater auricular nerve) (1 min)
- Drilling new meato-cocleo-mastoid Fallopian canal (1 min)
- Preparation of proximal stump of the Facial Nerve for grafting (30 sec)
- Preparation of distal stump of the Facial Nerve for grafting (30 sec)
- Introduction of single nerve graft (30 sec)
- Proximal coaptation of nerve graft (2 min)
- Distal coaptation of nerve graft (3 min)
- Wound closure (30 sec)
Video No
04b
3D
✔
Duration
45min
Surgeon
Prof. Ugo Fisch
Video Editing
Dr. Arnold H. Müller