Category Archives: Otolaryngology

PUBLISHED: Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

Tobias Carling, MD, PhD, FACS
Yale School of Medicine

With improvement in both preoperative parathyroid tumor identification and the use of intraoperative parathyroid hormone assay, minimally invasive parathyroidectomy (MIP) is now performed more frequently in patients with primary hyperparathyroidism (pHPT). Still, many institutions are not familiar with performing MIP under regional or local anesthesia. Here, Dr. Tobias Carling presents an MIP performed under local cervical block anesthesia on a patient with pHPT and parathryoid adenoma.

PUBLISHED: Zenker’s Diverticulum: Endoscopic Staple-Assisted Diverticulotomy

Zenker’s Diverticulum: Endoscopic Staple-Assisted Diverticulotomy

Seth M. Cohen, MD, MPH1David Straka, MD1Blaine D. Smith, MD1Douglas O’Connell, MSc2C. Scott Brown, MD1

1Duke University Medical Center
2College of Osteopathic Medicine, Touro University California

In this case, a patient with a symptomatic Zenker’s diverticulum is treated with an endoscopic staple-assisted diverticulotomy. The clinical presentation, diagnostic criteria, surgical procedure, and postoperative care are highlighted.

PUBLISHED: Trans-Oral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)

Trans-Oral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)
Yale School of Medicine

Courtney Gibson, MD, MS, FACS
Assistant Professor of Endocrine Surgery
Yale School of Medicine

Tobias Carling, MD, PhD, FACS
Chief of Endocrine Surgery
Yale School of Medicine

In this case, Dr. Tobias Carling and Dr. Courtney Gibson at Smilow Cancer Hospital at Yale New Haven perform a TOETVA on a 45-year-old patient who presented with a growing thyroid nodule that was shown to be a Hurthle cell neoplasm on fine-needle aspiration.

Numerous minimally-invasive approaches to thyroidectomy have been developed over the years to minimize the neck surgical scar, many of which are performed using endoscopic or robotic assistance. However, a more diminutive anterior cervical scar still remains a problem for some patients, as well as more extensive dissections for remote access operations. Therefore, natural orifice surgery was adopted at select institutions in an effort to perform a truly scarless thyroidectomy. Trans-oral endoscopic thyroidectomy has been the latest approach developed, known as the natural orifice transluminal endoscopic thyroidectomy, which is categorized as a natural orifice transluminal endoscopic surgery (NOTES) procedure. There are several ways to perform the natural orifice transluminal endoscopic thyroidectomy. Here, the authors present the TOETVA under general anesthesia.

PREPRINT RELEASE: Endoscopic Stapedectomy

Endoscopic Stapedectomy
Bascom Palmer Eye Institute

C. Scott Brown, MD
Neurotology & Lateral Skull Base Surgery Fellow
University of Miami Miller School of Medicine

Michael E. Hoffer, MD
Professor of Otolaryngology and Neurological Surgery
University of Miami Miller School of Medicine

Endoscopic ear surgery can improve visualization of critical structures. In this video, Dr. Scott Brown performs an endoscopic stapedectomy for the treatment of conductive hearing loss. He explains his technique and the advantages afforded by adoption of the endoscope in ear surgery.

PREPRINT RELEASE: Temporal Bone Dissection (Cadaver)

Temporal Bone Dissection (Cadaver)
Cranial Access, Neuroanatomy, and ENT Surgery (CANES) Lab

C. Scott Brown, MD
Neurotology & Lateral Skull Base Surgery Fellow
University of Miami Miller School of Medicine

Cadaveric dissections of the temporal bone are a critical part of learning otologic surgery in residency. Dr. Scott Brown, neurotology fellow at the University of Miami, performs a step-by-step dissection of the temporal bone. He outlines key anatomical structures and describes safe and efficient techniques for these procedures.

PREPRINT RELEASE: Microscope Drape for Aerosol-Generating Procedures During COVID-19 Pandemic

Microscope Drape for Aerosol-Generating Procedures During COVID-19 Pandemic
Bascom Palmer Eye Institute

C. Scott Brown, MD
Neurotology and Lateral Skull Base Surgery Fellow
University of Miami Miller School of Medicine

Fred F. Telischi, MEE, MD, FACS
James R. Chandler Chair in Otolaryngology
Chairman of Otolaryngology and Professor, Neurological Surgery and Biomedical Engineering
University of Miami Miller School of Medicine

During the COVID-19 pandemic, viral transmission via aerosolized particles poses the risk of infecting operating room staff. In this video, Dr. Telischi at the University of Miami demonstrates one of several techniques for draping the microscope during cochlear implant surgery.

OTO-Open: The Role of Video Atlases in Surgical Education

Surgical videos are a valuable resource in medical education – they help residents and students prepare for the operating room.


Dr. Scott Brown, the medical editor responsible for the creation of the Otolaryngology Section at JOMI, has published in OTO-Open an article “Development of a Surgical Video Atlas for Resident Education: 3-Year Experience“.  In this article, Dr. Brown discusses his journey, selection of cases, filming processes and challenges, and adoption of the content by residents and students.  Dr. Brown also discusses how surgical video atlases impact surgical training and the role they will play for ENT and other surgical residencies in the coming years.

https://doi.org/10.1177/2473974X20939067

PREPRINT RELEASE: Direct Microlaryngoscopy and Excision of Vocal Cord Lesion

Direct Microlaryngoscopy and Excision of Vocal Cord Lesion
Duke University Medical Center

Seth M. Cohen, MD, MPH
Associate Professor of Surgery
Division of Head and Neck Surgery & Communication Sciences

C. Scott Brown, MD
Resident Physician
Department of Surgery
Division of Head and Neck Surgery & Communication Sciences

In this case, Dr. Brown and Dr. Cohen perform a direct microlaryngoscopy and excise a vocal cord lesion.

PREPRINT RELEASE: Bonebridge Implant


Bonebridge Implant
Duke University Medical Center

David M. Kaylie, MD, MS
Department of Surgery
Division of Head and Neck Surgery & Communication Sciences

C. Scott Brown, MD
Resident Physician
Division of Head and Neck Surgery & Communication Sciences

A patient developed single-sided deafness after a middle fossa craniotomy for resection of a vestibular schwannoma. Dr. Kaylie demonstrates the steps for a mastoid placement of a Bonebridge implant.

PREPRINT RELEASE: Stapedotomy (Endaural)


Stapedotomy (Endaural)
Duke University Medical Center

David M. Kaylie, MD, MS
Department of Surgery
Division of Head and Neck Surgery & Communication Sciences

C. Scott Brown, MD
Resident Physician
Division of Head and Neck Surgery & Communication Sciences

Dr. David Kaylie demonstrates the endaural approach to the middle ear in order to perform a stapedotomy for conductive hearing loss secondary to otosclerosis. This technique can be utilized for other middle ear conditions, including attic cholesteatomas.