Revision ear and lateral skull base surgery:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2006
|
| Schriftenreihe: | Otolaryngologic clinics of North America
39,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIII S., S. 661 - 844 zahlr. Ill. |
| ISBN: | 1416039252 |
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| 650 | 4 | |a Ear |x surgery | |
| 650 | 4 | |a Otologic Surgical Procedures | |
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Datensatz im Suchindex
| _version_ | 1804135574699769856 |
|---|---|
| adam_text | REVISION EAR AND LATERAL SKULL BASE SURGERY
CONTENTS
Preface xi
Richard J. Wiet and Robert A. Battista
Dedication xiii
Richard J. Wiet and Robert A. Battista
Revision Tympanoplasty Including Anterior Perforations
and Lateralization of Grafts 661
J.V.D. Hough
Not long ago, the restoration of a perforated tympanic membrane
by grafting over an air containing tympanic cavity seemed impos¬
sible. Fortunately, successful results are so consistent and universal
today that restoration of the tympanic membrane is expected, and
a failure calls for careful evaluation as to why. If known princi¬
ples are observed, few complications need occur. Usually compli¬
cations are the result of either the choice and placement of the
graft used in the repair, or the presence of unresolved upper re¬
spiratory pathology. When revision tympanoplasty is necessary,
use of the underlay fascial graft technique, properly applied, usually
can solve any difficult problems.
Revision Stapedectomy 677
Robert A. Battista, Richard J. Wiet, and Jennifer Joy
Revision stapedectomy can be a technically demanding operation.
The surgeon must be prepared for many pathologic conditions
before revision stapes surgery. Appropriate preoperative patient
counseling is a must. The best chance for hearing improvement is
in those cases that have a delayed conductive hearing loss after pri¬
mary stapedectomy. This article serves as a guideline for discussing
the myriad possibilities that may be encountered during this type
of revision stapedectomy. Indications for revision stapedectomy
and general surgical guidelines for management of specific patho¬
logic conditions are discussed. The material presented is based on
VOLUME 39 • NUMBER 4 • AUGUST 2006 V
literature review, the authors personal experience, and a review of
temporal bone studies relative to stapes surgery.
Revision Ossiculoplasty 699
Ravi N. Samy and Myles L. Pensak
Although ossiculoplasty, also known as ossicular chain reconstruc¬
tion (OCR), was attempted initially in the early 1900s, it was not until
the 1950s that it became commonplace and relatively well under¬
stood. Since then, there have been numerous technologic advances
and a gain in the understanding of ossiculoplasty. However, success¬
ful OCR with resulting long term stability can be a daunting task.
Typically, the most common condition requiring revision OCR is
chronic suppurative otitis media (COM) with or without cholestea
toma. Primary and revision OCR are performed also for blunt and
penetrating trauma induced conductive hearing loss, congenital
defects (eg, atresia), and benign and malignant tumors. Typically, re¬
construction in ears with COM is more difficult than in ears without
infection. This article discusses the key factors involved in successful
revision OCR.
Endolymphatic Sac Revision for Recurrent Intractable
Meniere s Disease 713
Michael M. Paparella
Meniere s disease can be observed uniquely in revisions of the con¬
servative surgical procedure for endolymphatic sac enhancement,
which preserves the labyrinth, unlike destructive procedures. Ge¬
netic anatomic abnormalities in patients lead to malabsorption of
endolymph and symptoms of Meniere s that are reversed by endo¬
lymphatic sac enhancement, but disabling symptoms eventually
may recur in a few cases and require revisional surgery. We observe
developing pathophysiologic conditions intraoperatively and have
modified our techniques to accommodate the redeveloped patho
genesis we observe and avoid complications found with earlier
techniques. This conservative treatment allows patients (many of
whom may develop bilateral Meniere s) to retain capacity to accept
cochlear implants should they become advisable later.
Revision Mastoidectomy 723
Joseph B. Nadol Jr.
The first three priorities in surgery for chronic otitis media are (1)
the elimination of progressive disease to produce a safe and dry
ear, (2) modification of the anatomy of the tympanomastoid com¬
partment to prevent recurrent disease, and (3) reconstruction of
the hearing mechanism. The indications for revision following
mastoidectomy for chronic otitis media thus involve failure to
achieve any of these goals, including recurrent cholesteatoma, re¬
current suppuration, recurrent perforation, or recurrent or residual
conductive hearing loss. The focus of this article is the management
vi CONTENTS
of recurrent cholesteatoma or suppuration; that is, failure to
achieve either of the first two priorities.
Revision Surgery for Vertigo 741
John F. Kveton
When confronted with vertigo after an otologic procedure, a sur¬
geon first must identify the functional status of the inner ear by
performing auditory and vestibular testing. Using this informa¬
tion in conjunction with knowledge of the primary disease pro¬
cess for which the initial procedure was performed, the surgeon
can make a rational selection of the procedure required to elimi¬
nate vertigo. This article outlines a systematic approach to the se¬
lection of the appropriate revision procedure and discusses the
specific advantages and disadvantages of these procedures used
to control vertigo.
Acoustic Neuroma (Vestibular Schwannoma) Revision 751
Richard J. Wiet, Robert P. Kazan, Ivan Ciric,
and Philip D. Littlefield
The authors present their experience of more than 25 years, now in
excess of 1200 patients, with cerebellopontine angle tumors. This
article focuses on the management of planned subtotal resection
of acoustic tumors in five subjects, and unexpected residual dis¬
covered by MRI scanning in 10 cases, which represents, to the best
of the authors knowledge, a residual rate of 1% of operated pa¬
tients. The rate of residual tumor is as high as 19% in some series
and, in part, depends on the surgical approach. For the purpose
of this article, the authors did not include their cases of neurofibro
matosis, because these tumors behave differently than unilateral
sporadic schwannomas.
Revision Glomus Tumor Surgery 763
Mario Sanna, Giuseppe De Donato, Paolo Piazza,
and Maurizio Falcioni
The infratemporal fossa approach type A is the best way to deal
with recurrent tympano jugular paragangliomas because facial
nerve rerouting is fundamental to reaching the area of the internal
carotid artery, where recurrence is likely to occur. Preservation of
lower cranial nerve function is not feasible when there is tumor in¬
filtration of the medial wall of the jugular bulb; any attempt at
nerve dissection increases the risk of leaving some tumor remnants.
Correct management of the internal carotid artery, including pre
operative stent insertion or permanent preoperative balloon occlu¬
sion, is usually a fundamental step when dealing with these highly
vascularized lesions. Because of the tumor tendency to infiltrate
the bony structures, aggressive drilling of the temporal bone is also
advised, especially at the level of the petrous apex. Patients affected
by uncontrolled recurrences still die of this disease.
CONTENTS vii
The Challenges of Revision Skull Base Surgery 783
Anh Nguyen Huynh, Nikolas H. Blevins,
and Robert K. Jackler
Because the skull base is an anatomically complex structure, skull
base tumors can hide easily in the crevices that interconnect the in
tra and extracranial spaces and intermingle with important neuro
vascular structures. Often, total surgical resection of these tumors
is not possible, and even with postoperative adjuvant radiotherapy,
some recurrences after treatment are inevitable. Early detection of
recurrent skull base tumors requires clinical vigilance and periodic
imaging studies. The management of recurrent skull base tumors
presents many challenges beyond those associated with primary
procedures. A multidisciplinary setting that includes modern mi¬
crosurgery and stereotactic radiation therapy provides patients
with optimal care.
Revision BAHA Surgery 801
Robert A. Battista and Philip D. Littlefield
The osseointegrated auditory implant (BAHA) is a system used for
hearing rehabilitation through direct bone conduction. Although
BAHA surgery is not difficult, the surgeon must observe meticu¬
lous technique to prevent complications. Indications for revision
BAHA surgery can be divided into (1) failure of fixture osseointe
gration; (2) bone overgrowth; or (3) skin reaction or skin loss. This
article discusses the conditions that might predispose a patient to
require BAHA revision, and the steps, if any, that can be taken to
prevent these complications. Specific surgical steps for revision of
each of the three conditions are also addressed.
Revision Facial Nerve Surgery 815
Arvind Kumar, John Ryzenman, and Arlene Barr
Transection of the facial nerve can result from blunt or penetrating
trauma to the face or temporal bone. It can also occur accidentally
during surgery, or as a planned surgical procedure carried out in
the interest of eradicating disease. If transection is recognized at sur¬
gery, direct anastomosis or cable grafting is the procedure of choice.
This article presents two cases with neither clinical nor electrical evi¬
dence of recovery. The authors review current understanding of the
changes that occur in the neuron, axon, and muscle after injury to
the nerve, and the underlying pathology that led to graft failure
in these cases. They also evaluate surgical options and diagnostic
test results that help in selecting appropriate surgical procedures.
Revision Cochlear Implantation 833
J. Thomas Roland Jr., Tina C. Huang, and Noel L. Cohen
Reoperation on a patient with an indwelling cochlear implant is
uncommon. When necessary, surgery is performed for explantation
viii CONTENTS
of an existing device with immediate or delayed reimplantation, or
for scalp flap revision and receiver stimulator repositioning in the
case of infection or device migration. Rarely, revision surgery is
performed to reintroduce intracochlear electrodes that may have
partly or entirely extruded from the cochlea or were placed inap¬
propriately. Successful revision cochlear implant surgery requires
attention to certain surgical principles. Good outcomes, as mea¬
sured by speech perception tests, are common, but are not guaran¬
teed. This article outlines the indications for revision cochlear
implant surgery, the recommended surgical principles, and pub¬
lished outcomes from reimplantation.
Index 841
CONTENTS «
|
| adam_txt |
REVISION EAR AND LATERAL SKULL BASE SURGERY
CONTENTS
Preface xi
Richard J. Wiet and Robert A. Battista
Dedication xiii
Richard J. Wiet and Robert A. Battista
Revision Tympanoplasty Including Anterior Perforations
and Lateralization of Grafts 661
J.V.D. Hough
Not long ago, the restoration of a perforated tympanic membrane
by grafting over an air containing tympanic cavity seemed impos¬
sible. Fortunately, successful results are so consistent and universal
today that restoration of the tympanic membrane is expected, and
a failure calls for careful evaluation as to "why." If known princi¬
ples are observed, few complications need occur. Usually compli¬
cations are the result of either the choice and placement of the
graft used in the repair, or the presence of unresolved upper re¬
spiratory pathology. When revision tympanoplasty is necessary,
use of the underlay fascial graft technique, properly applied, usually
can solve any difficult problems.
Revision Stapedectomy 677
Robert A. Battista, Richard J. Wiet, and Jennifer Joy
Revision stapedectomy can be a technically demanding operation.
The surgeon must be prepared for many pathologic conditions
before revision stapes surgery. Appropriate preoperative patient
counseling is a must. The best chance for hearing improvement is
in those cases that have a delayed conductive hearing loss after pri¬
mary stapedectomy. This article serves as a guideline for discussing
the myriad possibilities that may be encountered during this type
of revision stapedectomy. Indications for revision stapedectomy
and general surgical guidelines for management of specific patho¬
logic conditions are discussed. The material presented is based on
VOLUME 39 • NUMBER 4 • AUGUST 2006 V
literature review, the authors' personal experience, and a review of
temporal bone studies relative to stapes surgery.
Revision Ossiculoplasty 699
Ravi N. Samy and Myles L. Pensak
Although ossiculoplasty, also known as ossicular chain reconstruc¬
tion (OCR), was attempted initially in the early 1900s, it was not until
the 1950s that it became commonplace and relatively well under¬
stood. Since then, there have been numerous technologic advances
and a gain in the understanding of ossiculoplasty. However, success¬
ful OCR with resulting long term stability can be a daunting task.
Typically, the most common condition requiring revision OCR is
chronic suppurative otitis media (COM) with or without cholestea
toma. Primary and revision OCR are performed also for blunt and
penetrating trauma induced conductive hearing loss, congenital
defects (eg, atresia), and benign and malignant tumors. Typically, re¬
construction in ears with COM is more difficult than in ears without
infection. This article discusses the key factors involved in successful
revision OCR.
Endolymphatic Sac Revision for Recurrent Intractable
Meniere's Disease 713
Michael M. Paparella
Meniere's disease can be observed uniquely in revisions of the con¬
servative surgical procedure for endolymphatic sac enhancement,
which preserves the labyrinth, unlike destructive procedures. Ge¬
netic anatomic abnormalities in patients lead to malabsorption of
endolymph and symptoms of Meniere's that are reversed by endo¬
lymphatic sac enhancement, but disabling symptoms eventually
may recur in a few cases and require revisional surgery. We observe
developing pathophysiologic conditions intraoperatively and have
modified our techniques to accommodate the redeveloped patho
genesis we observe and avoid complications found with earlier
techniques. This conservative treatment allows patients (many of
whom may develop bilateral Meniere's) to retain capacity to accept
cochlear implants should they become advisable later.
Revision Mastoidectomy 723
Joseph B. Nadol Jr.
The first three priorities in surgery for chronic otitis media are (1)
the elimination of progressive disease to produce a safe and dry
ear, (2) modification of the anatomy of the tympanomastoid com¬
partment to prevent recurrent disease, and (3) reconstruction of
the hearing mechanism. The indications for revision following
mastoidectomy for chronic otitis media thus involve failure to
achieve any of these goals, including recurrent cholesteatoma, re¬
current suppuration, recurrent perforation, or recurrent or residual
conductive hearing loss. The focus of this article is the management
vi CONTENTS
of recurrent cholesteatoma or suppuration; that is, failure to
achieve either of the first two priorities.
Revision Surgery for Vertigo 741
John F. Kveton
When confronted with vertigo after an otologic procedure, a sur¬
geon first must identify the functional status of the inner ear by
performing auditory and vestibular testing. Using this informa¬
tion in conjunction with knowledge of the primary disease pro¬
cess for which the initial procedure was performed, the surgeon
can make a rational selection of the procedure required to elimi¬
nate vertigo. This article outlines a systematic approach to the se¬
lection of the appropriate revision procedure and discusses the
specific advantages and disadvantages of these procedures used
to control vertigo.
Acoustic Neuroma (Vestibular Schwannoma) Revision 751
Richard J. Wiet, Robert P. Kazan, Ivan Ciric,
and Philip D. Littlefield
The authors present their experience of more than 25 years, now in
excess of 1200 patients, with cerebellopontine angle tumors. This
article focuses on the management of planned subtotal resection
of acoustic tumors in five subjects, and unexpected "residual" dis¬
covered by MRI scanning in 10 cases, which represents, to the best
of the authors' knowledge, a residual rate of 1% of operated pa¬
tients. The rate of residual tumor is as high as 19% in some series
and, in part, depends on the surgical approach. For the purpose
of this article, the authors did not include their cases of neurofibro
matosis, because these tumors behave differently than unilateral
sporadic schwannomas.
Revision Glomus Tumor Surgery 763
Mario Sanna, Giuseppe De Donato, Paolo Piazza,
and Maurizio Falcioni
The infratemporal fossa approach type A is the best way to deal
with recurrent tympano jugular paragangliomas because facial
nerve rerouting is fundamental to reaching the area of the internal
carotid artery, where recurrence is likely to occur. Preservation of
lower cranial nerve function is not feasible when there is tumor in¬
filtration of the medial wall of the jugular bulb; any attempt at
nerve dissection increases the risk of leaving some tumor remnants.
Correct management of the internal carotid artery, including pre
operative stent insertion or permanent preoperative balloon occlu¬
sion, is usually a fundamental step when dealing with these highly
vascularized lesions. Because of the tumor tendency to infiltrate
the bony structures, aggressive drilling of the temporal bone is also
advised, especially at the level of the petrous apex. Patients affected
by uncontrolled recurrences still die of this disease.
CONTENTS vii
The Challenges of Revision Skull Base Surgery 783
Anh Nguyen Huynh, Nikolas H. Blevins,
and Robert K. Jackler
Because the skull base is an anatomically complex structure, skull
base tumors can hide easily in the crevices that interconnect the in
tra and extracranial spaces and intermingle with important neuro
vascular structures. Often, total surgical resection of these tumors
is not possible, and even with postoperative adjuvant radiotherapy,
some recurrences after treatment are inevitable. Early detection of
recurrent skull base tumors requires clinical vigilance and periodic
imaging studies. The management of recurrent skull base tumors
presents many challenges beyond those associated with primary
procedures. A multidisciplinary setting that includes modern mi¬
crosurgery and stereotactic radiation therapy provides patients
with optimal care.
Revision BAHA Surgery 801
Robert A. Battista and Philip D. Littlefield
The osseointegrated auditory implant (BAHA) is a system used for
hearing rehabilitation through direct bone conduction. Although
BAHA surgery is not difficult, the surgeon must observe meticu¬
lous technique to prevent complications. Indications for revision
BAHA surgery can be divided into (1) failure of fixture osseointe
gration; (2) bone overgrowth; or (3) skin reaction or skin loss. This
article discusses the conditions that might predispose a patient to
require BAHA revision, and the steps, if any, that can be taken to
prevent these complications. Specific surgical steps for revision of
each of the three conditions are also addressed.
Revision Facial Nerve Surgery 815
Arvind Kumar, John Ryzenman, and Arlene Barr
Transection of the facial nerve can result from blunt or penetrating
trauma to the face or temporal bone. It can also occur accidentally
during surgery, or as a planned surgical procedure carried out in
the interest of eradicating disease. If transection is recognized at sur¬
gery, direct anastomosis or cable grafting is the procedure of choice.
This article presents two cases with neither clinical nor electrical evi¬
dence of recovery. The authors review current understanding of the
changes that occur in the neuron, axon, and muscle after injury to
the nerve, and the underlying pathology that led to graft failure
in these cases. They also evaluate surgical options and diagnostic
test results that help in selecting appropriate surgical procedures.
Revision Cochlear Implantation 833
J. Thomas Roland Jr., Tina C. Huang, and Noel L. Cohen
Reoperation on a patient with an indwelling cochlear implant is
uncommon. When necessary, surgery is performed for explantation
viii CONTENTS
of an existing device with immediate or delayed reimplantation, or
for scalp flap revision and receiver stimulator repositioning in the
case of infection or device migration. Rarely, revision surgery is
performed to reintroduce intracochlear electrodes that may have
partly or entirely extruded from the cochlea or were placed inap¬
propriately. Successful revision cochlear implant surgery requires
attention to certain surgical principles. Good outcomes, as mea¬
sured by speech perception tests, are common, but are not guaran¬
teed. This article outlines the indications for revision cochlear
implant surgery, the recommended surgical principles, and pub¬
lished outcomes from reimplantation.
Index 841
CONTENTS « |
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| index_date | 2024-07-02T15:25:44Z |
| indexdate | 2024-07-09T20:42:40Z |
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| isbn | 1416039252 |
| language | English |
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| physical | XIII S., S. 661 - 844 zahlr. Ill. |
| publishDate | 2006 |
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| publisher | Saunders |
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| series | Otolaryngologic clinics of North America |
| series2 | Otolaryngologic clinics of North America |
| spelling | Revision ear and lateral skull base surgery guest ed. Richard J. Wiet ... Philadelphia [u.a.] Saunders 2006 XIII S., S. 661 - 844 zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier Otolaryngologic clinics of North America 39,4 Chirurgie (geneeskunde) gtt Gehoororgaan gtt Schedelbasis gtt Ear surgery Otologic Surgical Procedures Skull Base surgery Wiet, Richard J. Sonstige (DE-588)131578022 oth Otolaryngologic clinics of North America 39,4 (DE-604)BV000003387 39,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014942472&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Revision ear and lateral skull base surgery Otolaryngologic clinics of North America Chirurgie (geneeskunde) gtt Gehoororgaan gtt Schedelbasis gtt Ear surgery Otologic Surgical Procedures Skull Base surgery |
| title | Revision ear and lateral skull base surgery |
| title_auth | Revision ear and lateral skull base surgery |
| title_exact_search | Revision ear and lateral skull base surgery |
| title_exact_search_txtP | Revision ear and lateral skull base surgery |
| title_full | Revision ear and lateral skull base surgery guest ed. Richard J. Wiet ... |
| title_fullStr | Revision ear and lateral skull base surgery guest ed. Richard J. Wiet ... |
| title_full_unstemmed | Revision ear and lateral skull base surgery guest ed. Richard J. Wiet ... |
| title_short | Revision ear and lateral skull base surgery |
| title_sort | revision ear and lateral skull base surgery |
| topic | Chirurgie (geneeskunde) gtt Gehoororgaan gtt Schedelbasis gtt Ear surgery Otologic Surgical Procedures Skull Base surgery |
| topic_facet | Chirurgie (geneeskunde) Gehoororgaan Schedelbasis Ear surgery Otologic Surgical Procedures Skull Base surgery |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014942472&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000003387 |
| work_keys_str_mv | AT wietrichardj revisionearandlateralskullbasesurgery |