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Videos

Filter between Skull base or Temporal Bone – Otology Videos.

Demo Video Play video

Video No
0
3D
Duration
15min

Infratemporal fossa approach type A anatomical dissection Play video

Part 1 (Right side)
Video No
1a
3D
Duration
35min

Highlights

  1. Skin Incision (13 min)
  2. Exposure of Facial Nerve in the Parotid region (7 min)
  3. Exposure of main Nerves and Vessels in the Neck (5 min)
  4. Exposure of Temporal squama (2 min)
  5. Subtotal Petrosectomy (5 min)

Infratemporal fossa approach type A anatomical dissection Play video

Part 2 (Right side)
Video No
1b
3D
Duration
66min

Highlights

  1. Subtotal petrosectomy (cont.): skeletonization and exposure of tympanic and mastoid segments of the Facial Nerve – removal of stapes arch (12 min)
  2. New anterior bony groove for anterior transposition of Facial Nerve – exposure of geniculate ganglion (2 min)
  3. Exposure of Internal Carotid Artery – Oblteration of tympanic ostium of Eustachian Tube (2 min)
  4. Anterior transposition of Facial Nerve (10 min)
  5. Ligation of Sigmoid Sinus (4 min)
  6. Placement of Infratemporal Fossa Retractor (4 min)
  7. Protection of anteriorly displaced Facial Nerve (2 min)
  8. Anterior exposure: Internal Carotid Artery, tympanic Ostium of Eustachian Tube (7 min)
  9. Superior exposure: Basal turn of Cochlea (3 min)
  10.  Posterior exposure: Posterior Fossa Dura, Sigmoid Sinus, Jugular Bulb (5 min)
  11. Inferior exposure: Jugular vein, XI Nerve, opening of Jugular Bulb, pars venosa and pars nervosa of jugular foramen (12 min)
  12. Anatomical situation after removal of a tumor that did not invade the cerebello-pontine-angle (1 min)
  13. New fallopian canal in the Temporal Squama for grafting of the Facial Nerve with Superior Temporal Rerouting (2 min)

Infratemporal fossa approach type A for removal of C2 paragangliomas Play video

Part 1-2
Video No
2
3D
Duration
78min

Part 1: Removal of C2 Paraganglioma (Right side 65 min)

Highlights 

  1. Preoperative Radiology (1 min)
  2. Introduction with Figures (6 min)
  3. Subtotal Petrosectomy (8 min)
  4. Exposure of tympanic and mastoid Segment of the Facial Nerve using Facial Nerve Monitor ( 3 min)
  5. Elevation and anterior transposition of Facial Nerve ( 7 min)
  6. Exposure and ligation of Sigmoid Sinus (5 min)
  7. Exposure of vertical intratemporal segment of Internal Carotid Artery, occlusion of Tympanic Ostium of Eustachian Tube ( 5 min)
  8. Tumor exposure (16 min)
    1. Anterior Pole (2 min)
    2. Superior Pole (3 min)
    3. Posterior Pole (3 min)
    4. Inferior Pole (8 min)
  9. Tumor removal (12 min)
  10. Wound closure (1 min)

Part 2: Segmental removal of infiltrated Epineurium after anterior rerouting of the Facial Nerve (Left side 13 min)

Highlights

  1. Preoperative Radiology (1 min)
  2. Introduction with Figures (4 min)
  3. Segmental removal of Epineurium with anterior Rerouting of the Facial Nerve after removal of a C2 Paraganglioma (7 min)

Infratemporal fossa Approach Type A for removal of a C2De2Di1 jugular Schwannoma Play video

Left side
Video No
3
3D
Duration
82min

Highlights:

  1. Introduction and preoperative radiology (6 min)
  2. Subtotal Petrosectomy (7 min)
  3. Exposure and mobilization of the intrapetrousFacial Nerve (5 min)
  4. Anterior transposition of the Facial Nerve (18 min)
  5. Exposure and ligation of Sigmoid Sinus (4 min)
  6. Exposure of ICA at the skull base (4 min)
  7. Introduction of infratemporal fossa retractor (1 min)
  8. Exposure of inferior tumor pole (1 min)
  9. Mobilization of superior tumor pole (5 min)
  10. Obliteration of Isthmus of the Eustachian Tube (1 min)
  11. Separation of anterior tumor pole from ICA (4 min)
  12. Mobilization of posterior tumor pole (2 min)
  13. Mobilization of inferior tumor pole (4 min)
  14. Separation of medial tumor extension from the posterior fossa dura (5 min)
  15. Removal of intradural tumor extension (7 min)
  16. Wound closure (2 min)
  17. Postoperative radiology (1 min)

Facial nerve surgery 1 Play video

Subtotal Petrosectomy with tympano-mastoid double grafting after iatrogenic injury of the Facial Nerve (Right side)
Video No
4a
3D
Duration
37min

Highlights:

  1. Preoperative information incl. radiology ( 2 min)
  2. Mastoidectomy (3 min)
  3. Canalplasty (3 min)
  4. Identification of traumatized Facial Nerve (3 min)
  5. Decision to perform Subtotal Petrosectomy with preservation of otic capsule (3 min)
  6. Exposure of traumatized Facial Nerve (1 min)
  7. Exenteration of hypotympanic and infralabyrinthine pneumatic cells (1 MIN)
  8. Obliteration of Eustachian tube (2 min)
  9. Preparation of Facial Nerve for grafting (6 min)
  10. Preparation of Nerve graft (1 min)
  11. Tympano-mastoid double grafting of Facial Nerve (8 min)
  12. Wound closure (2 min)

Facial nerve surgery 2 Play video

Part 1-2
Video No
4b
3D
Duration
45min

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:

  1. Introduction with Figures ( 5 min)
  2. Transmastoid Approach (4 min):
    1. exposure of mastoid, pyramidal and tympanic segments of the Facial Nerve (1 min)
    2. Identification of Facial Nerve lesion (3 min)
  3. Transtemporal (MCF) Approach (5 min):
    1. exposure of genu and labyrinthine segment of the Facial Nerve (4 min)
    2. meato-tympanic rerouting of Fallopian canal (1 min)
  4. Transmastoid approach (1 min): elevation of proximal stump of FN and enlargement of the Fallopian canal with the drill
  5. Transtemporal (MCF) Approach (4 min):
    1. decompression of lateral cistern of the posterior fossa (1 min)
    2. section of petrosal nerve distal to geniculum and of labyrinthine segment of the FN (1 min)
  6. Measurement, Harvesting and preparation of graft from the greater auricular nerve (2 min)
  7. Transmastoid Approach (1 min): introduction of double nerve graft
  8. Transtemporal (MCF) Approach (4 min):
    1. double grafting of proximal stump of the FN (3 min)
    2. wound closure with free muscle graft and craniotomy flap (1 min)
  9. Transmastoid approach: double grafting of distal stump of the FN (2 min) 
  10. 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:

  1. Introduction with figures (5 min)
  2. Mastoidectomy with exposure of fracture line from oval window to supralabyrinthine recess (2 min)
  3. Identification of traumatized tympanic segment of Facial Nerve (30 sec)
  4. Removal of otic capsula leaving the medial portion of the basal turn (1 min)
  5. Section of petrosal nerve and mobilization of the swollen labyrinthine segment of the Facial Nerve (1 min)
  6. Harvesting and preparation of the nerve graft (greater auricular nerve) (1 min)
  7. Drilling new meato-cocleo-mastoid Fallopian canal (1 min)
  8. Preparation of proximal stump of the Facial Nerve for grafting (30 sec)
  9. Preparation of distal stump of the Facial Nerve for grafting (30 sec)
  10. Introduction of single nerve graft (30 sec)
  11. Proximal coaptation of nerve graft (2 min)
  12. Distal coaptation of nerve graft (3 min)
  13. Wound closure (30 sec)

Infratemporal fossa approach type A for removal of a C3 paraganglioma Play video

Left side
Video No
5
3D
Duration
50min

Highlights:

  1. Information with Figures (6 min)
  2. Separation of superior pole of tumor (2 min)
  3. Separation of posterior pole of tumor (1 min)
  4. Exposure of inferior tumor pole (3 min)
  5. Exposure of anterior tumor pole (3 min)
  6. Separation of tumor from ICA and cranial nerves at the jugular foramen (2 min)
  7. Removal of tumor along vertical intrapetrous segment of ICA (4 min)
  8. Removal of tumor from otic capsula (1 min)
  9. Removal of tumor from the pyramid apex (2 min)
  10. Removal of tumor remnants in the spongiotic bone (3 min)
  11. Removal of last portion of tumor at the carotid bend (6 min)
  12. Further removal of infiltrated spongiotic bone (12 min)
  13. Final view after tumor removal(1 min)
  14. Operative specimen and wound closure (1 min)

Infratemporal Fossa Approach Type B Play video

Anatomical Dissection (right side) and 3 clinical cases
Video No
6
3D
Duration
75min

2ndt Part Clinical Cases

Case 1: Removal of apical cyst (Lt 22 min)

Case 2: Drainage of apical cyst (Rt 10 min)

Case 3: lRemoval of epidermoid cyst – apical cholesteatoma (Rt 11 min)

Highlights

  1. Retroauriculo-temporal skin incision
  2. Main trunk and frontal branch of the facial nerve identified
  3. Zygomatic arch and temporalis muscle reflected inferiorly
  4. Subtotal petrosectomy
  5. Horizontal intratemporal carotid artery, middle meningeal artery and mandibular nerve exposed by removal of mandibibular tubercle
  6. Mandibular condyle displaced inferiorly
  7. Pyramid tip and clivus exposed for tumor removal
  8. Wound obliterated with temporalis muscle

Anatomical Dissection Play video

Right side
Video No
1
3D
Duration
69min

Part 1: Tympano-Antrotomy (56 min)

1. Skin Incision (10 sec)
2. Meatoplasty (10 sec)
3. Canalplasty (25 min)
4. Myringoplasty (8 min)
5. Antrotomy (5 min)
6. Epitympanotomy (2 min)
7. Transmastoid Drainage of the Antrum (30 sec)
8. Myringoplasty (6 min)
9. Ossiculoplasty (6 min)

Part 2: Tympano-Mastoidectomy (13 min)

10. Mastoidectomy (6 min)
11. Posterior Tympanotomy (7 min)

Tympano Antrotomy Play video

Clinical Case (right side)
Video No
2
3D
Duration
32min

Highlights

  1. Canalpasty (10 min)
  2. Myringoplasty (8 min)
  3. Antrotomy (1 min)
  4. Epitympanotomy (1 min)
  5. Ossiculoplasty (1 min)
  6. Mastoid Drainage (1 min)
  7. Wound Closure (4 min)

With original intraoperative comments by Prof. U.F

Tympano Mastoidectomy Play video

Closed Cavity Clinical Case (left side)
Video No
3
3D
Duration
84min

Highlights

  1. Canalplasty (12 min)
  2. Mastoidectomy (11 min)
  3. Posterior Tympanotomy (27 min)
  4. Removal of skin from Middle Ear (8 min)
  5. Myringoplasty (3 min)
  6. Epitympanotomy (1 min)
  7. Ossiculoplasty (5 min)
  8. Mastoid Drainage (1 min)

With original intraoperative comments by Prof. U.F.

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

Clinical case (right side)
Video No
4
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)

Incudo-Stapedotomy Play video

Amatom. Dissection and Clin. Cas Endaural Approach
Video No
5a
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

Malleo-Stapedotomy Play video

Anatom. Dissection and Clin. Cases Endaural Approach (Right Side)
Video No
5b
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

Open Mastoido-Epitympanectomy Play video

Temp. Bone Dissection (Right side)
Video No
6a
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

Open Mastoido-Epitympanectomy with Tympanoplasty Type III Play video

Clinical Case (secondary acquired attic cholesteatoma) (Right side)
Video No
6b
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 with Tympanoplasty (first stage) Play video

Removal of a secondery acquired attic Cholesteatoma and partial Obliteration Clinical Case (Left side)
Video No
6c
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

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
6d
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 (Type III) and posterior Obliteration Play video

Indication: Chronic otitis media with subtotal perforation and secondary acquired Cholesteatoma - Clinical Case (Left side)
Video No
6e
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

 

 

Surgery of the External Auditory Canal Play video

Clinical Cases
Video No
7
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

Cochlear Implant Play video

Clinical Cases
Video No
7
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