By Henning Hildmann, Holger Sudhoff, Stefan Dazert, Rudolf Hagen
ISBN-10: 3642194974
ISBN-13: 9783642194979
ISBN-10: 3642194982
ISBN-13: 9783642194986
This lavishly illustrated handbook comprises outstanding paintings and provides a special review of all very important constructions of, and surgical options for, the center ear and the temporal bone, including:
- Outer elements of the temporal bone
- Mastoid preparations
- Mastoidectomy
- Posterior tympanotomy
- Cochleostomy
- Facial nerve decompression
- Mastoid cavity
- Labyrinthectomy
- Middle ear preparations
- Exercises in tympanoplasty
- Approaches to the inner auditory canal
- Topographical reviews of the temporal bone
This guide presents the reader with the information essential to commence working on sufferers. It additionally helps specialists to enhance and educate their skills.
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Extra info for Manual of Temporal Bone Exercises
Sample text
The internal auditory canal appears as a grey change in colour beneath the bone. The facial nerve is closer to the surface ascending from the internal auditory canal toward the geniculate ganglion. The canal must be identified in its total length and must be exposed at least in 180° of its circumference before removeing the last layer of the remaining thin bone. In actual surgery, this technique avoids cerebrospinal fluid (CSF) displacing the nerves into the field of drilling. 29a, b). 1 Clinical Application • Vestibular vertigo with serviceable hearing • Small acoustic neuromas Landmarks Greater petrosal nerve Arcuate eminence Blue line of the superior semicircular canal 3 Surgical Exercises in the Middle Ear The posterior external auditory wall should be intact.
13 The Translabyrinthine Approach to the Internal Auditory Canal The first steps are mastoidectomy, identification of the semicircular canals, and stepwise labyrinthectomy as described above. The mastoid must be opened widely to give a good overview. Remove bone up to the middle cranial fossa and posteriorly toward the posterior fossa. A protruding sigmoid sinus can be pushed downward and a high jugular bulb can be lowered. Exposure of the internal auditory canal requires extensive drilling resulting in a circumference around the internal auditory canal of about 300°.
Expect it to be up to about 10 mm distant. 28). When drilling the superior semicircular canal, damage to the facial nerve and the cochlea must be avoided. Identify the superior petrosal sinus. The groove of the greater petrosal nerve leading to the geniculate ganglion and the arcuate eminence can be identified. Air cells might be found above the superior semicircular canal before the yellow labyrinthine bone is seen. The “blue line” is identified in a longer stretch without fenestration of the canal.