Middle Ear and Mastoid Microsurgery

Contents 1 Anatomy of the Temporal Bone 2 Operating Room Setup 3 Anesthesia Local Anesthesia General Anesthesia 4 General Technical Considerations Drilling Suction and Irrigation Hemostasis Dissection 5 Decision Making in Middle Ear Surgery Strategy in the Only Hearing Ear Staging Strategy Strategy for Revision Surgery 6 Ventilation Tube Insertion 7 General Surgical Procedures Retroauricular Skin Incision Harvesting the Grafting Materials Incision of the External Auditory Canal Canalplasty (Calibration of the Bony Canal Walls) Skin Closure 8 Pre- and Postoperative Care Preoperative Care Postoperative Care 9 External Auditory Canal Exostosis and Osteoma Hints and Pitfalls for Exostosis Stenosis of the External Auditory Canal Hints and Pitfalls for Canal Stenosis Cholesteatoma of the External Auditory Canal 10 Myringoplasty Retroauricular Myringoplasty Transcanal Myringoplasty Problems and Solutions in Myringoplasty Revision Myringoplasty Hints and Pitfalls for Myringoplasty 11 Ossiculoplasty Considerations Regarding Atelectasis and Adhesive Otitis Media Considerations Regarding Tympanosclerosis Hints and Pitfalls for Ossiculoplasty Revision Ossiculoplasty 12 Simple Mastoidectomy 13 Canal Wall Up (Closed) Tympanoplasty Second Stage and Revision Surgery after Canal Wall Up Technique Hints and Pitfalls 14 Canal Wall Down (Open) Tympanoplasty Canal Wall Down (Open) Tympanoplasty Meatoplasty Packing and Closure Hints and Pitfalls Modified Bondy Technique Hints and Pitfalls of the Modified Bondy Technique Radical Mastoidectomy Second Stage Surgery in Open Technique Revision Surgery after Open Technique Hints and Pitfalls of Revision Surgery 15 Special Considerations Regarding Glomus Tumor (Class A and B) 16 Problems and Solutions in Mastoid Surgery Labyrinthine Fistula Bone Erosion in the Tegmen Facial Nerve Paralysis New Bone Formation Meningoencephalic and Dural Herniation 17 Stapes Surgery Problems and Solutions Hints and Pitfalls for Stapes Surgery Revision Stapes Surgery Hints and Pitfalls for Revision Stapes Surgery 18 Obliteration of the Middle Ear 19 Cochlear Implant 20 Management of Iatrogenic Injuries Bleeding from the Dura Bleeding from the Sigmoid and Other Sinuses Bleeding from the Jugular Bulb CSF Leak Labyrinthine Fistula Disarticulation of the Incus Fracture of the Stapes Tear in the Tympanic Membrane Tear in the Meatal Skin Facial Nerve Injury References Index