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Author	Adunka, Oliver F
Title	Otology, neurotology, and lateral skull base surgery : an illustrated handbook / Oliver F. Adunka, Craig A. Buchman
Publish Info	Stuttgart ; New York : Thieme, c2011

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U of Cincinnati HEALTH SCI Stacks WV 200 A244o 2011 AVAILABLE

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Contents

Contributors xi

Foreword xv

Preface xvii

Acknowledgments and Biography xix

List of Abbreviations xxi

1. History of Otology 1

2. Basic Principles 5

Anatomy of the Temporal Bone and Adjacent Structures 6

Overview of Temporal Bone Anatomy 6

Anatomy of the External Ear and Eustachian Tube 9

Anatomy of the Middle Ear 12

Anatomy of the Inner Ear 16

Anatomy of the Internal Auditory Canal, Jugular Foramen, and Petrous Apex 19

Central Auditory and Vestibular Pathways 22

Physiology 25

Physiology of the Auditory System 25

Physiology of the External Ear 25

Physiology of the Middle Ear 27

Auditory Physiology of the Inner Ear 30

Central Auditory Pathways 33

Physiology of the Vestibular System 36

Balance Physiology of the Inner Ear 36

Central Vestibular Processing 39

Peripheral Nerves, CNS, and CSF 42

Physiology of Peripheral Nerves 42

Central Nervous System / CSF 42

3. Otologic and Neurotologic Diagnostics and Tests 45

Physical Examination 46

General Otologic/Neurotologic Physical Examination 46

The Neurotologic Cranial Nerve Examination 49

Evaluation of Hearing 53

Clinical Evaluation 53

Behavioral Testing 55

Objective Audiometry 58

Assessment of Middle Ear Function 58

Otoacoustic Emissions 61

Auditory Brainstem Response 64

Other Auditory Evoked Potentials: Electrocochleography, Auditory Steady-State Responses, and Cortical Potentials 67

Evaluation of the Balance System 70

Clinical Evaluation 70

Basic Principles 70

DIX-Hallpike Test 73

Objective Balance Testing 77

Electronystagmography 77

Computerized Platform Posturography 81

Vestibular Evoked Myogenic Potentials 84

Evaluation of the Facial Nerve 87

Clinical Evaluation of the Facial Nerve 87

Objective Testing of the Facial Nerve 90

Imaging of the Temporal Bone 92

Conventional Radiography 92

Computed Tomography 95

Magnetic Resonance Imaging 98

Conventional MRI 98

Magnetic Resonance Angiography and Venography 101

Other Imaging Procedures 103

Digital Subtraction Angiography 103

Nuclear Medicine 103

4. Disease-Specific Diagnostics and Medical Management 107

External Ear 108

Congenital Malformations of the External Ear 108

Acute Infections of the External Ear 111

Chronic Infections of the External Auditory Canal 114

Benign Tumors of the External Auditory Canal 117

Malignant Neoplasms of the External Ear 120

Middle Ear 123

Malformations of the Middle Ear and External Auditory Canal 123

Acute Otitis Media and Otitis Media with Effusion 126

Chronic Suppurative Otitis Media (Chronically Draining Ear) 130

Chronic Suppurative Otitis Media without Cholesteatoma, Adhesive Otitis Media, and Granulomatous Middle Ear Disease 130

Cholesteatoma 136

Complications of Otitis Media 141

Temporal Bone Encephalocele 145

Neoplasms of the Middle Ear 148

Benign Neoplasms of the Middle Ear 148

Malignant Neoplasms of the Middle Ear 151

Otosclerosis 154

Inner Ear 158

Sensorineural Hearing Loss 158

Congenital Sensorineural Hearing Impairment 158

Early-Acquired Hearing Loss and Auditory Neuropathy 162

Occupational and Noise-Induced Hearing Loss and Ototoxicity 165

Sudden Sensorineural Hearing Loss and Presbyacusis 168

Autoimmune Hearing Loss and Perilymphatic Fistula 171

Tinnitus and Hyperacusis 175

Disorders of the Vestibular System 179

Vestibular Neuronitis 179

Benign Paroxysmal Positional Vertigo 182

Other Causes of Balance Disturbance 185

Meniere Disease 188

Medial Temporal Bone 192

Internal Auditory Canal and Cerebellopontine Angle 192

Vestibular Schwannoma 192

Overview of Vestibular Schwannoma 192

Neurofibromatosis Type 2 195

Radiation Therapy 198

Miscellaneous Disorders of the IAC and CPA 200

Benign Neoplasms of Other Cranial Nerves 200

Meningiomas of the CPA 203

Rare Diseases of the CPA and IAC 206

Disorders of the Petrous Apex 209

Lesions of the Jugular Foramen 212

Disorders of the Facial Nerve 216

General Principles of the Facial Nerve 216

Bell Palsy and Ramsay-Hunt Syndrome 219

Iatrogenic Facial Nerve Injuries 222

Central Neurotologic Disorders 224

Migraine Vestibulopathy 224

Demyelinating Disorders 228

Multiple Sclerosis 228

Otologic and Neurotologic Sequelae of Meningitis 231

Increased Intracranial Pressure 235

Neurotologic Sequelae of Stroke 238

Seizure Disorders 241

Vascular Compression Syndromes 244

Fractures of the Temporal Bone 247

Audiologic Management of Hearing Loss 250

Amplification of Hearing 250

Cochlear Implants 253

Auditory Brainstem Implants 256

5. Surgical Therapy of the Temporal Bone 259

Otologic/Neurotologic Instrumentation 260

Intraoperative Monitoring 263

Surgical Access to the Mastoid and Middle Ear, Grafting Materials 267

Considerations for Pediatric Ear Surgery 273

Canaloplasty of the External Ear Canal 277

Temporal Bone Resections for Malignant Disease 280

Surgical Management of Aural Atresia 283

Management of Middle Ear Trauma 287

Surgical Management of Acute Otitis Media and Chronic Otitis Media with Effusion 291

Middle Ear Ventilation Surgery 291

Mastoidectomy 295

Surgery for Chronic Otitis Media 299

Myringoplasty and Underlay Tympanoplasty 299

Lateral Graft Tympanoplasty 303

Ossiculoplasty 306

Tympanomastoid Procedures 310

Surgery for Otosclerosis 317

Surgical Management of the Facial Nerve 320

Management of Facial Nerve Neoplasms 320

Management of Traumatic Facial Palsy 323

Surgical Management of Bell Palsy 326

Surgery for Implantable Auditory Devices 328

Surgery for Cochlear Implants 328

Surgery for Bone-Anchored Hearing Aids 331

Surgery for Implantable Hearing Aids 334

Neurotologic Approaches to the Medial Temporal Bone 338

Middle Fossa Approach 338

Retrolabyrinthine Approach 341

Translabyrinthine Approach 343

Transcochlear Approach 346

Retrosigmoid/Suboccipital Approach 348

Combined Approaches to the Cerebellopontine Angle 350

Surgical Management of Chronic Vestibular Disorders 353

General Considerations 353

Chemical Labyrinthectomy 356

Translabyrinthine and Middle Fossa Vestibular Neurectomy 359

Retrosigmoid, Retrolabyrinthine, and Combined Vestibular Neurectomy 362

Cochleosacculotomy and Singular Neurectomy; Posterior Semicircular Canal Occlusion 365

Labyrinthectomy 368

Indolymphatic Sac Surgery 371

Surgery for Vestibular Schwannoma 374

Infratemporal Fossa Approaches 377

Surgery for Lesions of the Petrous Apex 381

6. Management of Complications 385

Rehabilitation of Cranial Nerve Deficits 386

Vestibular Rehabilitation 390

Treatment of the Eye and Disorders of the Facial Nerve 393

Management of Postoperative Cerebrospinal Fluid Leakages 395

7. Temporal Bone Dissection 399

General Considerations 400

Introduction 400

Specimen Handling 400

Laboratory Set-up 401

Position 402

Dissecting Technique 402

The Temporal Bone 402

Lateral Dissection 403

Topography 403

Cortical Mastoidectomy 404

Facial Recess 408

Extended Facial Recess 408

Retrolabyrinthine/Infralabyrinthine 411

Supralabyrinthine/Supracochlear 413

Labyrinthectomy 413

Internal Auditory Canal (Translabyrinthine) 414

Canal Wall Down 416

Infracochlear 416

Transcochlear 420

Superior Exposure 422

Surface Topography 422

Internal Auditory Canal 423

Inner Ear 423

Middle Ear 426

Petrous Apex 426

Posterior Exposure 428

Surface Topography 428

Internal Auditory Canal 429

Endolymphatic System and Inner Ear 431

Jugular Foramen 431

Index 435

Description xxiii, 448 p. : ill. (chiefly col.) ; 25 cm

Note Includes bibliographical references and index

Contents History of otology -- Basic principles -- Otologic and neurotologic diagnostics and tests -- Disease-specific diagnostics and medical management -- Surgical therapy of the temporal bone -- Management of complications -- Temporal bone dissection

Summary "Expanding developments in the field have prompted a welcome increase among interested students. Interventions that were once considered somewhat esoteric by some might now be considered part of the medical mainstream. Cochlear implantation is certainly an example of such an intervention. As a consequence of these developments, a need to convey the core fund of knowledge to a larger more diverse group of trainees has arisen. With this in mind, this book was created to provide the basic concepts of otology, neurotology, and lateral skull base surgery in a rather simple, illustrated format for the new student interested in the field. While not intended to replace the more comprehensive, authoritative works in the field, this manual is meant only to create a "jumping on" point for continued study"--Provided by publisher

Subjects Otology -- Handbooks, manuals, etc

Ear -- Innervation -- Handbooks, manuals, etc

Temporal bone -- Surgery -- Handbooks, manuals, etc

Skull base -- Surgery -- Handbooks, manuals, etc

Otologic Surgical Procedures -- methods

Craniotomy -- methods

Ear -- surgery

Skull Base -- surgery

Alt Name Buchman, Craig A

LC NO RF130 .A38 2011

Nlm No 2010 L-947

WV 200 A244o 2011

Dewey No 617.8/059 22

OCLC # 640072292

Isn/Std # 10,N26 dnb

ISBN 9783131450210 (hardback)

3131450215 (hardback)

Isn/Std # (OCoLC)640072292 (OCoLC)320802487

LCCN 2010023089

	Contributors	xi
	Foreword	xv
	Preface	xvii
	Acknowledgments and Biography	xix
	List of Abbreviations	xxi
1.	History of Otology	1
2.	Basic Principles	5
	Anatomy of the Temporal Bone and Adjacent Structures	6
	Overview of Temporal Bone Anatomy	6
	Anatomy of the External Ear and Eustachian Tube	9
	Anatomy of the Middle Ear	12
	Anatomy of the Inner Ear	16
	Anatomy of the Internal Auditory Canal, Jugular Foramen, and Petrous Apex	19
	Central Auditory and Vestibular Pathways	22
	Physiology	25
	Physiology of the Auditory System	25
	Physiology of the External Ear	25
	Physiology of the Middle Ear	27
	Auditory Physiology of the Inner Ear	30
	Central Auditory Pathways	33
	Physiology of the Vestibular System	36
	Balance Physiology of the Inner Ear	36
	Central Vestibular Processing	39
	Peripheral Nerves, CNS, and CSF	42
	Physiology of Peripheral Nerves	42
	Central Nervous System / CSF	42
3.	Otologic and Neurotologic Diagnostics and Tests	45
	Physical Examination	46
	General Otologic/Neurotologic Physical Examination	46
	The Neurotologic Cranial Nerve Examination	49
	Evaluation of Hearing	53
	Clinical Evaluation	53
	Behavioral Testing	55
	Objective Audiometry	58
	Assessment of Middle Ear Function	58
	Otoacoustic Emissions	61
	Auditory Brainstem Response	64
	Other Auditory Evoked Potentials: Electrocochleography, Auditory Steady-State Responses, and Cortical Potentials	67
	Evaluation of the Balance System	70
	Clinical Evaluation	70
	Basic Principles	70
	DIX-Hallpike Test	73
	Objective Balance Testing	77
	Electronystagmography	77
	Computerized Platform Posturography	81
	Vestibular Evoked Myogenic Potentials	84
	Evaluation of the Facial Nerve	87
	Clinical Evaluation of the Facial Nerve	87
	Objective Testing of the Facial Nerve	90
	Imaging of the Temporal Bone	92
	Conventional Radiography	92
	Computed Tomography	95
	Magnetic Resonance Imaging	98
	Conventional MRI	98
	Magnetic Resonance Angiography and Venography	101
	Other Imaging Procedures	103
	Digital Subtraction Angiography	103
	Nuclear Medicine	103
4.	Disease-Specific Diagnostics and Medical Management	107
	External Ear	108
	Congenital Malformations of the External Ear	108
	Acute Infections of the External Ear	111
	Chronic Infections of the External Auditory Canal	114
	Benign Tumors of the External Auditory Canal	117
	Malignant Neoplasms of the External Ear	120
	Middle Ear	123
	Malformations of the Middle Ear and External Auditory Canal	123
	Acute Otitis Media and Otitis Media with Effusion	126
	Chronic Suppurative Otitis Media (Chronically Draining Ear)	130
	Chronic Suppurative Otitis Media without Cholesteatoma, Adhesive Otitis Media, and Granulomatous Middle Ear Disease	130
	Cholesteatoma	136
	Complications of Otitis Media	141
	Temporal Bone Encephalocele	145
	Neoplasms of the Middle Ear	148
	Benign Neoplasms of the Middle Ear	148
	Malignant Neoplasms of the Middle Ear	151
	Otosclerosis	154
	Inner Ear	158
	Sensorineural Hearing Loss	158
	Congenital Sensorineural Hearing Impairment	158
	Early-Acquired Hearing Loss and Auditory Neuropathy	162
	Occupational and Noise-Induced Hearing Loss and Ototoxicity	165
	Sudden Sensorineural Hearing Loss and Presbyacusis	168
	Autoimmune Hearing Loss and Perilymphatic Fistula	171
	Tinnitus and Hyperacusis	175
	Disorders of the Vestibular System	179
	Vestibular Neuronitis	179
	Benign Paroxysmal Positional Vertigo	182
	Other Causes of Balance Disturbance	185
	Meniere Disease	188
	Medial Temporal Bone	192
	Internal Auditory Canal and Cerebellopontine Angle	192
	Vestibular Schwannoma	192
	Overview of Vestibular Schwannoma	192
	Neurofibromatosis Type 2	195
	Radiation Therapy	198
	Miscellaneous Disorders of the IAC and CPA	200
	Benign Neoplasms of Other Cranial Nerves	200
	Meningiomas of the CPA	203
	Rare Diseases of the CPA and IAC	206
	Disorders of the Petrous Apex	209
	Lesions of the Jugular Foramen	212
	Disorders of the Facial Nerve	216
	General Principles of the Facial Nerve	216
	Bell Palsy and Ramsay-Hunt Syndrome	219
	Iatrogenic Facial Nerve Injuries	222
	Central Neurotologic Disorders	224
	Migraine Vestibulopathy	224
	Demyelinating Disorders	228
	Multiple Sclerosis	228
	Otologic and Neurotologic Sequelae of Meningitis	231
	Increased Intracranial Pressure	235
	Neurotologic Sequelae of Stroke	238
	Seizure Disorders	241
	Vascular Compression Syndromes	244
	Fractures of the Temporal Bone	247
	Audiologic Management of Hearing Loss	250
	Amplification of Hearing	250
	Cochlear Implants	253
	Auditory Brainstem Implants	256
5.	Surgical Therapy of the Temporal Bone	259
	Otologic/Neurotologic Instrumentation	260
	Intraoperative Monitoring	263
	Surgical Access to the Mastoid and Middle Ear, Grafting Materials	267
	Considerations for Pediatric Ear Surgery	273
	Canaloplasty of the External Ear Canal	277
	Temporal Bone Resections for Malignant Disease	280
	Surgical Management of Aural Atresia	283
	Management of Middle Ear Trauma	287
	Surgical Management of Acute Otitis Media and Chronic Otitis Media with Effusion	291
	Middle Ear Ventilation Surgery	291
	Mastoidectomy	295
	Surgery for Chronic Otitis Media	299
	Myringoplasty and Underlay Tympanoplasty	299
	Lateral Graft Tympanoplasty	303
	Ossiculoplasty	306
	Tympanomastoid Procedures	310
	Surgery for Otosclerosis	317
	Surgical Management of the Facial Nerve	320
	Management of Facial Nerve Neoplasms	320
	Management of Traumatic Facial Palsy	323
	Surgical Management of Bell Palsy	326
	Surgery for Implantable Auditory Devices	328
	Surgery for Cochlear Implants	328
	Surgery for Bone-Anchored Hearing Aids	331
	Surgery for Implantable Hearing Aids	334
	Neurotologic Approaches to the Medial Temporal Bone	338
	Middle Fossa Approach	338
	Retrolabyrinthine Approach	341
	Translabyrinthine Approach	343
	Transcochlear Approach	346
	Retrosigmoid/Suboccipital Approach	348
	Combined Approaches to the Cerebellopontine Angle	350
	Surgical Management of Chronic Vestibular Disorders	353
	General Considerations	353
	Chemical Labyrinthectomy	356
	Translabyrinthine and Middle Fossa Vestibular Neurectomy	359
	Retrosigmoid, Retrolabyrinthine, and Combined Vestibular Neurectomy	362
	Cochleosacculotomy and Singular Neurectomy; Posterior Semicircular Canal Occlusion	365
	Labyrinthectomy	368
	Indolymphatic Sac Surgery	371
	Surgery for Vestibular Schwannoma	374
	Infratemporal Fossa Approaches	377
	Surgery for Lesions of the Petrous Apex	381
6.	Management of Complications	385
	Rehabilitation of Cranial Nerve Deficits	386
	Vestibular Rehabilitation	390
	Treatment of the Eye and Disorders of the Facial Nerve	393
	Management of Postoperative Cerebrospinal Fluid Leakages	395
7.	Temporal Bone Dissection	399
	General Considerations	400
	Introduction	400
	Specimen Handling	400
	Laboratory Set-up	401
	Position	402
	Dissecting Technique	402
	The Temporal Bone	402
	Lateral Dissection	403
	Topography	403
	Cortical Mastoidectomy	404
	Facial Recess	408
	Extended Facial Recess	408
	Retrolabyrinthine/Infralabyrinthine	411
	Supralabyrinthine/Supracochlear	413
	Labyrinthectomy	413
	Internal Auditory Canal (Translabyrinthine)	414
	Canal Wall Down	416
	Infracochlear	416
	Transcochlear	420
	Superior Exposure	422
	Surface Topography	422
	Internal Auditory Canal	423
	Inner Ear	423
	Middle Ear	426
	Petrous Apex	426
	Posterior Exposure	428
	Surface Topography	428
	Internal Auditory Canal	429
	Endolymphatic System and Inner Ear	431
	Jugular Foramen	431
	Index	435