Comparative Atlas of Endoscopic Ear Surgery: Training Techniques Based on an Ovine Model

✍ Scribed by Marco Bonali (editor), Livio Presutti (editor), Daniele Marchioni (editor)

• Publisher: Springer
• Year: 2021
• Tongue: English
• Leaves: 332
• Category: Library

✦ Synopsis

This unique, richly illustrated atlas offers a “how-to” reference guide to the most common and innovative endoscopic surgical procedures for the middle and inner ear, based on an ex vivo ovine model. Moreover, it compares this model to the same approaches in humans, underlying the essential surgical tips and tricks.

The transcanal endoscopic approach for the management of middle and inner ear pathologies is being increasingly used, but in some countries the lack of human specimens makes adequate training in this field difficult: in response, the book introduces a novel method performed on the animal model, which allows trainees to improve their skills, while reducing the cost of surgical training. It provides a full description of specimen preparation, and comparative anatomical and radiological analyses of the human and ovine models, guides readers through the main otologic operative techniques (e.g. canalplasty, miringoplasty and ossiculoplasty) step by step, and illustrates the best approach to the internal auditory canal.

Written by prominent experts in the field, this atlas serves as a unique reference resource for residents and young surgeons wishing to acquire first-hand the skills needed for endoscopic procedures and to improve their learning curves.

✦ Table of Contents

Foreword
Preface
Acknowledgements
Contents
List of Videos
1: Hints and Pitfalls: How to Start Endoscopic Ear Surgery Training
1.1 Introduction
1.2 Proposal of a Training Programme: Principles and General Features
1.3 Application of the Staged Training Programme to the Ovine Model
References
2: Surgical Instruments and Preparation of the Specimen
2.1 Introduction
2.2 Identification, Application, and Validation of the Surgical Model
2.3 Preparation of the Specimen and Setting (Fig. 2.1: Video 2.1)
2.3.1 Setting of the Dissection Lab
2.4 Surgical Instruments
References
3: Comparative Anatomy and Radiology: Human vs. Ovine Model
3.1 Introduction (Fig. 3.1)
3.2 External Auditory Canal and Tympanic Membrane (Figs. 3.2, 3.3, 3.4, and 3.5)
3.3 Ossicular Chain (Figs. 3.6, 3.7, 3.8, 3.9, 3.10, and 3.11)
3.3.1 Malleus
3.3.2 Incus
3.3.3 Stapes
3.4 Mesotympanum (Figs. 3.12 and 3.13)
3.5 Retrotympanum (Figs. 3.14, 3.15, 3.16, and 3.17)
3.6 Epitympanum (Figs. 3.18, 3.19, 3.20, 3.21, and 3.22)
3.7 Protympanum (Figs. 3.23, 3.24, and 3.25)
3.8 Hypotympanum (Figs. 3.26, 3.27, and 3.28)
3.9 Facial Nerve (Figs. 3.29, 3.30, 3.31, and 3.32)
3.10 Internal Auditory Canal (Figs. 3.33, 3.34, and 3.35)
3.11 Take Home Messages
References
4: Myringotomy and Transtympanic Ventilation Tube Positioning
4.1 Introduction
4.2 Indications
4.3 Surgical Steps in Human Procedure
4.3.1 Patient Positioning and Surgical Setting (Fig. 4.1)
4.3.1.1 Step 1: Exploration of the Tympanic Membrane and Incision (Fig. 4.2)
4.3.1.2 Step 2: Suction (Fig. 4.3)
4.3.1.3 Step 3: Ventilation Tube Positioning and Insertion (Figs. 4.4 and 4.5)
4.4 Hints and Pitfalls (Human)
4.5 Surgical Steps on Ovine Model
4.5.1 Surgical Instrumentations (Figs. 4.6, 4.7, and 4.8)
4.5.2 Surgical Steps (Fig. 4.9: Video 4.1)
4.5.2.1 Step 1: Incision (Figs. 4.10, 4.11, 4.12, 4.13, 4.14, and 4.15)
4.5.2.2 Step 2: Suction (Fig. 4.16)
4.5.2.3 Step 3: Ventilation Tube Positioning (Figs. 4.17, 4.18, 4.19, 4.20, 4.21, 4.22, 4.23, 4.24, 4.25, 4.26, and 4.27)
4.5.2.4 Step 4: Ventilation Tube Removal (Fig. 4.28)
4.6 Hints and Pitfalls (Ovine)
4.7 Take Home Messages
References
5: Endoscopic Approach to the Tympanic Cavity: Tympanomeatal Flap and Canalplasty
5.1 Introduction [1–3]
5.2 Indications
5.3 Surgical Steps in Human Procedure
5.3.1 Patient Positioning and Surgical Setting (Fig. 5.1)
5.3.1.1 Canalplasty: Exostoses/Osteomas Removal
5.3.1.2 Special Application: Atticotomy (Figs. 5.15 and 5.16)
5.4 Hints and Pitfalls (Human)
5.5 Surgical Steps on Ovine Model
5.5.1 Surgical Instrumentations (Figs. 5.17, 5.18, 5.19, and 5.20)
5.5.2 Surgical Steps (Fig. 5.21: Video 5.1)
5.6 Hints and Pitfalls (Ovine)
5.7 Take Home Messages
References
6: Myringoplasty
6.1 Introduction
6.2 Indications and Contraindications
6.2.1 Indications
6.2.2 Contraindications
6.3 Surgical Steps in Human Procedure
6.3.1 Patient Positioning and Surgical Setting (Fig. 6.1)
6.3.2 Surgical Steps
6.4 Hints and Pitfalls (Human)
6.5 Surgical Steps on Ovine Model
6.5.1 Surgical Instrumentations (Figs. 6.20, 6.21, and 6.22)
6.5.2 Surgical Steps (Fig. 6.23: Video 6.1)
6.6 Hints and Pitfalls (Ovine)
6.7 Take Home Messages
References
7: Ossiculoplasty
7.1 Introduction
7.2 Indications and Contraindications
7.2.1 Indications
7.2.2 Contraindications
7.3 Surgical Steps in Human Procedure
7.3.1 Patient Positioning and Surgical Setting (Fig. 7.1)
7.3.2 Surgical Steps
7.4 Hints and Pitfalls
7.5 Surgical Steps on Ovine Model
7.5.1 Surgical Instrumentation (Figs. 7.16, 7.17, and 7.18)
7.5.2 Surgical Steps (Fig. 7.19: Video 7.1)
7.6 Hints and Pitfalls
7.7 Take Home Message
References
8: Stapes Surgery
8.1 Introduction
8.2 Indications
8.3 Contraindications
8.4 Surgical Steps in Human Procedure
8.4.1 Patient Positioning and Surgical Setting (Fig. 8.1)
8.4.2 Surgical Steps
8.5 Hints and Pitfalls (Human)
8.6 Surgical Steps on Ovine Model
8.6.1 Surgical Instrumentation (Figs. 8.11, 8.12, and 8.13)
8.6.2 Surgical Steps (Fig. 8.15: Video 8.1)
8.6.2.1 Stapedotomy
8.6.2.2 Stapedectomy
8.7 Hints and Pitfalls (Ovine)
8.8 Take Home Messages
References
9: Round Window Dissection and Cochlear Implantation
9.1 Introduction
9.2 Indications [2–4]
9.3 Surgical Steps in Human Procedure
9.3.1 Transmastoid Posterior Tympanotomy Approach
9.3.1.1 Surgical Steps
9.3.2 Endoscope-Assisted Cochlear Implantation (Suprameatal Approach)
9.3.2.1 Endoscopic Steps
Patient Positioning and Surgical Setting (Fig. 9.1)
9.3.2.2 Microscopic Steps
Step 6: Microscopic Suprameatal Approach (Figs. 9.9 and 9.10)
9.3.3 Robotic-Assisted Cochlear Implantation
9.4 Hints and Pitfalls (Human)
9.4.1 Transmastoid Posterior Tympanotomy Approach
9.4.2 Endoscopic-Assisted Cochlear Implantation (Suprameatal Approach)
9.5 Surgical Steps on the Ovine Model
9.5.1 Surgical Instrumentation (Figs. 9.11, 9.12 and 9.13)
9.5.2 Surgical Steps (Fig. 9.15: Video 9.1 and Fig. 9.16: Video 9.2)
9.6 Hints and Pitfalls (Ovine)
9.7 Take Home Messages
References
10: Approach to Internal Auditory Canal
10.1 Introduction
10.2 Indications and Contraindications
10.2.1 Indications
10.2.2 Contraindications
10.3 Surgical Steps in Human Procedure
10.3.1 Patient Positioning and Surgical Setting (Fig. 10.1)
10.3.2 Surgical Steps
10.4 Hints and Pitfalls (Human)
10.5 Surgical Steps in the Ovine Model
10.5.1 Surgical Instrumentation (Figs. 10.23, 10.24, and 10.25)
10.5.2 Surgical Steps (Fig. 10.26: Video 10.1)
10.6 Hints and Pitfalls (Ovine)
10.7 Take Home Messages
References