Otoendoscopically Guided Surgery

ISBN-13: 9783642509650 / Angielski / Miękka / 2012 / 87 str.

J. -M Thomassin; M. E. Wigand; A. Pech

Opis

The endoscope with magnifying lens systems and retrotympanic sub-regions. During microsurgical pro angled view has, in all oto-rhino-laryngology, been cedures, the recognition of pathologic changes in developed from a basically diagnostical tool into a sur niches, recesses or occluded tunnels is considerably gical instrument. Earlier, it served to see what exists. facilitated. The disadvantages of the operating micro Nowadays, it is continuously changing what one does. scope -reduced brightness and bad focus with higher Jean-Marc Thomassin's book "Otoendoscopically magnifieations, no angled view- can be compensated guided surgey" appears as the first guide into this new by additional endoscopy with the instrument's tip field of otoendoscopic control of microsurgery of the close to the target and with the view "around the cor ear. The author has achieved to compile and codify ner." what, during recent years, was already looked at by While thus visualizing remote areas or hidden him and by a "happy few" of otological pilots. But, he spots by a rigid magnifying endoscope with an angled has also added new insights into this matter. One may view direction apparently no patho-anatomical secret say that he has provided a solid basis for both the remains undiscovered. What can be inspected can be scholars and the experts who want to enrich their cleaned, there are adequate instruments. This fact arsenal of otosurgical techniques. makes the analysis of surgical failures more plausible."

Spis treści

History.- Endoscopic anatomy of middle ear cavities.- Retrotympanic region of tympanic cavity.- Descriptive anatomy.- Endoscopic anatomy.- Sinus tympani.- Access to the sinus tympani is easy.- Access to the sinus tympani is difficult.- Intermediate cases.- Styloid eminence.- This study of the endoscopic anatomy leads to the following conclusions.- The protympanum.- The hypotympanum.- The anterior epitympanum.- References.- Otoscopic findings.- Positioning the patient.- Otoendoscopy.- Technique.- Decontamination of equipment.- Otoendoscopic findings.- Normal eardrum.- Abnormal eardrum.- Perforations.- Retraction pockets.- Cholesteatoma.- Endoscopic anatomy of pharyngeal orifice of auditory tube.- References.- Instrumentation.- Endoscopes.- For tympanic endoscopy.- For otovideoendoscopy of middle ear cavities.- Cold light source.- Cold light cable.- Microcamera.- Optical system support.- Decontamination and sterilisation of equipment.- Micro-instruments.- Endoscopic guided surgery with video monitoring.- Anesthesia.- General anesthesia — technique.- Preoperative period.- Operative period.- Supervision.- Recovery.- Local anesthesia.- Arrangement of operating room and patient.- Surgical techniques.- Surgery of cholesteatoma.- At initial operative stageof closed-technique tympanoplasty.- Otoendoscopic lesional assessment.- Peroperative endoscopy.- Cleaning of cavities.- Inspection of epitympanum.- Inspection of protympanum.- Inspection of retrotympanum.- With 0° system.- With 30° and 70° systems.- Excision of cholesteatoma under endoscopic guidance.- Second peroperative stage of closed-technique tympanoplasty.- Exploration of posterior cavities.- Inspection of mastoid cavity.- Inspection of epitympanum.- Inspection of tympanic cavity by posterior route.- Inspection of tympanic cavity and retrotympanum.- Inspection of tympanic cavity.- Ossiculoplasty.- Monitoring of the tympanic cavity by myringotomy technique.- Surgery of retraction pockets.- Posterior and posterosuperior invaginations.- Epitympanic invaginations.- References.- Indications.- Surgery of cholesteatoma.- In closed-technique tympanoplasties.- During the first operative stage.- During the second operative stage.- In open technique tympanoplasties.- Epidermisation of tympanic cavity.- Retraction pockets.- Techniques for reconstruction of old radical cavity.- Ossiculoplasties.- Congenital malformations.- Minor aplasias.- Major aplasias.- Other applications.- Search for a perilymphatic fistula.- Injuries of the ossicular chain.- Surgery of benign tumors.- Results of Otoendoscopically guided surgery in tympanoplasty for cholesteatoma.- Case material.- Distribution by age.- Macroscopic appearance and localisation.- Results.- Analysis of results with residual cholesteatoma.- The sites of residual cholesteatoma.- Frequency.- CT- endoscopic correlations in the second surgical stage of monitoring closed-technique tympanoplasties.- References.