Category Archives: Otolaryngology

PUBLISHED: Myringoplasty and Tympanostomy Tube Placement

Myringoplasty and Tympanostomy Tube Placement
C. Scott Brown, MD; David M. Kaylie, MD, MS
Duke University Medical Center

Eustachian tube dysfunction can often cause otitis media, tympanic membrane perforation, or conductive hearing loss. In this video article, myringoplasty was performed using a CO2 laser that provided reorganization of collagen fibers and improved compliance of the tympanic membrane. Given the ongoing eustachian tube dysfunction, a pressure equalization tube was placed to prevent recurrent retraction and atelectasis of the eardrum.

PUBLISHED: Endoscopic Stapedectomy

 

 

Endoscopic Stapedectomy

Scott Brown, MD, FACS
University of Miami Miller School of Medicine

Michael E. Hoffer, MD
University of Miami Miller School of Medicine

Benjamin Park
Vanderbilt University School of Medicine

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.

 

PUBLISHED: Bonebridge Implant

 

Bonebridge Implant

Scott Brown, MD
Duke University Medical Center

David M Kaylie, MD, MS
Duke University Medical Center

Cecilia G Freeman
Duke University Medical Center

Bone conduction implants can improve hearing in patients with conductive or mixed hearing loss as well as in cases of single-sided deafness (SSD). The patient in this case previously underwent resection of a vestibular schwannoma via a middle fossa craniotomy that ultimately resulted in SSD. Here, Dr. Kaylie at Duke University Medical Center demonstrates the step-by-step surgical technique for the Bonebridge implant to allow sound transmission from the patient’s deaf ear to the contralateral cochlea via bone conduction.

 

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