Cholesteatoma
Primary acquired cholesteatoma is an invagination of the tympanic membrane, of variable aggressiveness, with accumulation of desquamated keratin and a notable tendency to destroy bone. It is controversial whether cholesteatoma…
Tympanoplasty
The invention of microsurgical repair of chronic tympanic membrane perforation was one of the great contributions of 20th century otology. With success rates in experienced hands well over 90%, it…
Mastoidectomy
While most mastoid surgery is conducted for infection, mastoidectomy is also performed to create a pathway to the deeper recesses of the temporal bone. These include surgery for neoplasia, vestibular…
Fundamentals of Ear Surgery
2.2 Patient Positioning Fig. 2.1 The three variables for positioning of the head in ear microsurgery: rotation, tilt, and flexion–extension. Fig. 2.2 Incorrect positioning with the head under rotated, extended, and tilted. This…
Surgical Anatomy of the Ear
A rigorous understanding of anatomy underlies safe and effective ear microsurgery. Traditionally, anatomical dissection of temporal bones was the primary educational means of being introduced to the complex and convoluted…
Facial Nerve
Facial nerve injury is a risk in virtually all ear procedures and its injury is the most dreaded complication in routine otologic surgery. Historically, it was sometimes said that “God…
Ossiculoplasty
Diseases of the ossicular chain most often occur as an aftermath of infection and less commonly due to trauma or tumor. Conductive hearing loss may result from either discontinuity of…
Temporal Bone Fractures, Encephaloceles, and Cerebrospinal Fluid Leaks
12.2 Temporal Bone Fractures Fig. 12.1 Fractures through the petrous pyramid may result from either posterior or lateral blows to the head. The skull base fractures more easily when struck from the…
Cochlear Implants
Cochlear implantation remains one of modern medicine’s greatest innovations, having restored hearing to hundreds of thousands of individuals around the world. Refinements of implant technology and associated surgical techniques have…
Vestibular Surgery
10.2 Endolymphatic Sac Surgery Fig. 10.1 In preparation for exposure of the endolymphatic sac, an intact canal wall mastoidectomy is performed. In contrast to many drawings which appear in otologic texts, the…
