Stapedotomy (Endaural) David M. Kaylie, MD, MS1; Trey A. Thompson2; C. Scott Brown, MD1 1Duke University Medical Center 2University of Washington School of Medicine
Otosclerosis is a condition characterized by abnormal bone growth that inhibits the movement of the stapes, leading to a gradual conductive hearing loss. The treatment options encompass observation, the use of hearing aids, and surgical intervention. If the patient opts for surgery, either a stapedotomy or a stapedectomy can be executed to liberate the stapes from the sclerotic bone.
In the case of a stapedotomy performed with an endaural approach, access to the middle ear is gained through a minor incision extending from the anterior ear canal to the incisura, also known as the intertragal notch. The surgeon then proceeds to remove the superstructure of the stapes, create an opening in the footplate of the stapes, and subsequently place a prosthesis into the opening, which is then connected to the incus. The outcomes of this procedure are generally positive, with 90–95% of patients experiencing an improvement in hearing.
Cochlear Implant C. Scott Brown, MD; Calhoun D. Cunningham III, MD Duke University Medical Center
For patients who present with bilateral severe-to-profound sensorineural hearing loss who have little-to-no benefit from conventional hearing aids, cochlear implants can restore hearing by directly stimulating the cochlear nerve.
This video demonstrates the placement of a cochlear implant. A standard mastoidectomy and facial recess approach is performed to visualize the round window niche and membrane. The round window membrane is opened, and the cochlear implant electrode is carefully inserted into the scala tympani. After several weeks, the patient returns for implant activation with a dedicated team of audiologists.
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.
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.
Cochlear Implant Duke University Medical Center Calhoun D. Cunningham III, MD
C. Scott Brown MD
Department of Surgery
Division of Head and Neck Surgery & Communication Sciences
Dr. Cunningham demonstrates the round window approach for placement of an Advanced Bionics Cochlear Implant into the right ear of a patient with severe to profound sensorineural hearing loss. Emphasis on surgical anatomy and technique is emphasized as he performs this delicate neurotological procedure.
