Endolymphatic sac (ELS) decompression can be performed for patients with Meniere’s disease who have failed conservative treatment such as dietary changes and medical therapy. The full pathophysiological mechanisms that result in Meniere’s disease are not entirely understood. The variation in techniques for performing ELS decompression support this; there is no concrete data to justify one approach over another. Regardless, in the correct patient, ELS decompression can significantly alleviate the patient’s symptoms. To do so, a mastoidectomy is performed to expose the bony labyrinth as well as the bone overlying the sigmoid sinus. Decompression of the sac can be accomplished by removing overlying bone, incising the dura, or stenting the dura open.
Superior semicircular canal dehiscence (SSCD) is associated with conductive hearing loss, autophony, and pressure/sound induced vertigo. Patients who are symptomatic may elect to undergo surgical intervention.
Here, Dr. Kaylie demonstrates the transmastoid approach to repairing SSCD. This approach affords the opportunity for an outpatient procedure to expose and plug the canal around the defect.
Botox Injection
Charles R. Woodard, MD¹; Alexandra L. Elder, BS²; Helen A. Moses, MD¹; C. Scott Brown, MD¹ ¹Duke University Medical Center ²Thomas Jefferson University
Botox injection is one of the most common cosmetic procedures performed. Botox temporarily paralyzes targeted skeletal muscles of the face, reducing the patient’s ability to produce unwanted dynamic wrinkles. Commonly treated areas of the face include the procerus and corrugator supercilii muscles to treat glabellar frown lines, the frontalis muscle to treat horizontal rhytids of the forehead, and the orbicularis oculi muscle to treat “crow’s feet” wrinkles along the lateral aspect of the orbit.
A thorough facial analysis is necessary to develop a treatment plan for each problem area, particularly by engaging the patient to determine what his or her goals for treatment are. Providers must take care when injecting into the face to avoid complications of overtreatment, such as brow ptosis from over-injecting the forehead or elevated brow from over-injecting the periorbital muscles.
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.
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.
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.
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.
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.
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 with eustachian tube dysfunction and a history of multiple pressure equalization tubes presents to an otolaryngology clinic with complaints of hearing loss. Her eardrum was found to be hyperinflated on exam. Dr. David Kaylie demonstrates a myringoplasty technique using a CO2 laser, along with placement of a tympanostomy tube.
