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.
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.
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.
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.
“Utility of Annotated Surgical Case Videos for Resident Education: A Pilot Study” – presented by C. Scott Brown, MD at the Combined Otolaryngology Spring Meetings on April 19th & 20th.
Dr. C. Scott Brown at Duke used JOMI “to assess the educational value of annotated surgical videos on the comprehension of surgical anatomy and operative procedures.” The results: residents went from scoring 59.4% on a test before watching JOMI content to 93.6% afterwards (p = 0.001). The video used was Dr. Cunningham III and Dr. Brown’s “Laser Excision of Glomus Tympanicum (Transcanal Approach).”
While this was a small study, we are very excited to see the impact of video education (and especially JOMI articles) being rigorously quantified!
