By Michel Gersdorff, Jean-Marc Gérard
Packed with in actual fact classified, full-color drawings on each web page, Atlas of center Ear Surgery publications readers throughout the commonest and leading edge surgeries used to regulate center ear pathology.
The authors, specialists during this technically tough box, commence by means of offering useful history details on surgical anatomy and pathophysiology by means of a short creation to anesthesia concerns and working room etiquette. Full-color drawings then exhibit some of the surgical thoughts in a step by step format
that is superb for studying. Succinct, easy-to-understand descriptions accompany each drawing in a didactic demeanour that boosts basic techniques because it teaches.
- The most modern at the surgical administration of tympanic
membrane abnormalities, persistent otitis media, cholesteatoma, and ossicular
- 254 full-color drawings and schematics exhibit
anatomy and significant surgical steps
- Numerous callout packing containers in each one bankruptcy spotlight key
surgical guidance, pearls, and pitfalls
Concise and useful, this atlas is
essential analyzing for otolaryngology citizens, fellows, budding otologic
surgeons, or training ENTs who have to hone their surgical talents and remain abreast of the newest advances within the field.
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Extra info for Atlas of middle ear surgery
With a nasal speculum and spatula, the lateral meatal skin flap is replaced through the meatus. The Silastic sheet is pulled down and the packing is completed with large pieces of Spongostan. Fig. 63 Tip: To restore a perfect anterior angle, small Spongostan pieces can be inserted before placing the Silastic sheet. In the case of meatal skin flap defects and reconstructions with skin grafts or temporalis fascia, packing with Epifilm is performed. 10 Fig. 63 Special Tympanoplasty Techniques and Problems Special Tympanoplasty Techniques and Problems Indications for this technique are small or midsize perforations, not exceeding one-third of the tympanic membrane surface, located in the inferior or posterior quadrant.
10 Tympanic Membrane Approaches Vascular Strip Elevation A string or strip of gauze is pushed into the external canal and pulled out through the incision of the laterally based skin flap. Fig. 26 Optimal Exposure The string is attached to the surgical field with a clamp, and a self-retaining retractor is used to hold the musculoperiosteal and skin flaps in place. Good exposure is required to visualize the anterior wall and ensure an unimpaired view of the tympanic membrane. Fig. 27 Fig. 26 Tip: To achieve safe and adequate elevation of the laterally based skin flap, the strip needs to be as flat as possible.
Using electrocautery, the superior incision of the musculoperiosteal flap starts anteriorly at the level of the temporal line, running toward the posterior skin incision. Inferiorly, it ends at the inferior edge of the external auditory canal, creating an anteriorly based isoscel triangle centered on the inferior edge of the Henle spine. Fig. 20 Fig. 21 For mastoidectomy, the musculoperiosteal flap is enlarged into a trapezium to expose the mastoid process. Tip: Place your finger in the meatus it helps to localize the external auditory canal and to center the musculoperiosteal flap.