Download Atlas of Otologic Surgery by Marcos V. Goycoolea, Michael M. Paparella, Rick L. Nissen PDF

By Marcos V. Goycoolea, Michael M. Paparella, Rick L. Nissen

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Sample text

Perforating the tympanic membrane. Those of a simple mastoidectomy. Procedure Define your landmarks (Fig. 5 - 6 / 4 ) . The external genu of the facial nerve is medial; the fossa incudis is superior. Thin the posterior canal wall. Identify the facial nerve by its pearly white color underneath the thin layer of bone. The bone is still too thick; thin it down very carefully by drilling parallel to the direction of the facial nerve fibers (Fig. 5 - 6 8 ) . Small cutting burs should be used since the recess is quite small.

FIGURE 5-24 Procedures Surgical Procedures 82 Surgical Procedures Procedure below and behind the nerve, and the ampu;e of the horizontal canal inferiorly beneath the nervt (Fig. 53 3 / 1 , B ) . In this p r o c e s s , the utricle is d e s t o y e d as This procedure exposing both implies the middle an ear endaural and approach, mastoid cortex. well. " O n c e the round w i n d o w niche is clearly exposed and I m m e d i a t e l y inferior to the vestibule is the internal defined, an atticotomy (Fig.

Mobilize the stapes, using superiorto-inferior and inferior-to-superior movements, and 4 . E x p o s e t h e m a s t o i d c o r t e x a n d drill a m a s t o i d o t o m y (Lempert II incision). 5. P e r f o r m a s m a l l p o s t a u r i c u l a r i n c i s i o n a n d drill a seat for t h e internal receiver. 6. o the m a s t o i d o t o m y into the antrum, middle diately inferior to the capitulum (Fig. ear, and round w i n d o w niche. 5-26C). The r e m a i n i n g f o o t p l a t e p o r t i o n s a r e lifted g e n t l y w i t h a 7.

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