Introduction:Majority of petrous bone and lateral skull base pathologies are benign in nature.The complex anatomy usually warrants an extensive approach with associated morbidity.Case summary:Two cases of petrous bone...Introduction:Majority of petrous bone and lateral skull base pathologies are benign in nature.The complex anatomy usually warrants an extensive approach with associated morbidity.Case summary:Two cases of petrous bone cholesteatoma(1 congenital cholesteatoma with facial palsy and 1 acquired cholesteatoma)and a case of glomus tympanicum were treated with exclusive endoscopic transcanal approach.The cases of petrous cholesteatoma were addressed with trans-promontorial and infra-cochlear approaches.The mean operative time was approximately 140 min.No CSF otorrhoea was noticed in the post-operative period.The average period of hospital stay was 3.7 days.Conclusion:In the subset of cases with limited benign disease an endoscopic trans-canal approach is a better alternative to an external approach.It decreases operative time,blood loss,chance of meningitis,morbidity and hospital stay.The lack of depth perception is a major hurdle which can be come over by experience in endoscopic middle ear surgery.This approach can create direct access to cochlea/petrous apex/internal auditory canal(IAC)/Supra-geniculate ganglion region.展开更多
Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situatio...Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situations.Methods:This is a retrospective analysis of cases where a total of 46 patients(22 in conventional stapedotomy and 24 in CO_(2) laser‐assisted stapedotomy)were included in the study.The clinical parameters were assessed both in the preoperative and postoperative periods in the respective groups and later compared 12 weeks after stapedotomy.Results:A total of 90.90%(20/22)of the patients in the conventional stapedotomy and 95.83%(23/24)of patients in laser‐assisted stapedotomy had<20 dB of AB gap in the postoperative period(P=0.71).Canaloplasty was required in six patients in the conventional stapedotomy and none of the patients in the laser group needed the same(P=0.01).Chorda tympani nerve was manipulated in 59.09%(13/22)and 25.00%(6/24)of cases in the conventional group and in the CO_(2) laser group,respectively(P=0.01).Conclusion:Although the audiological outcomes with fiber‐enabled CO_(2) laser in endoscopic stapedotomy are comparable to conventional surgery,it is a better tool in a narrow auditory canal,requiring minimal manipulation of the chorda tympani nerve.展开更多
文摘Introduction:Majority of petrous bone and lateral skull base pathologies are benign in nature.The complex anatomy usually warrants an extensive approach with associated morbidity.Case summary:Two cases of petrous bone cholesteatoma(1 congenital cholesteatoma with facial palsy and 1 acquired cholesteatoma)and a case of glomus tympanicum were treated with exclusive endoscopic transcanal approach.The cases of petrous cholesteatoma were addressed with trans-promontorial and infra-cochlear approaches.The mean operative time was approximately 140 min.No CSF otorrhoea was noticed in the post-operative period.The average period of hospital stay was 3.7 days.Conclusion:In the subset of cases with limited benign disease an endoscopic trans-canal approach is a better alternative to an external approach.It decreases operative time,blood loss,chance of meningitis,morbidity and hospital stay.The lack of depth perception is a major hurdle which can be come over by experience in endoscopic middle ear surgery.This approach can create direct access to cochlea/petrous apex/internal auditory canal(IAC)/Supra-geniculate ganglion region.
文摘Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situations.Methods:This is a retrospective analysis of cases where a total of 46 patients(22 in conventional stapedotomy and 24 in CO_(2) laser‐assisted stapedotomy)were included in the study.The clinical parameters were assessed both in the preoperative and postoperative periods in the respective groups and later compared 12 weeks after stapedotomy.Results:A total of 90.90%(20/22)of the patients in the conventional stapedotomy and 95.83%(23/24)of patients in laser‐assisted stapedotomy had<20 dB of AB gap in the postoperative period(P=0.71).Canaloplasty was required in six patients in the conventional stapedotomy and none of the patients in the laser group needed the same(P=0.01).Chorda tympani nerve was manipulated in 59.09%(13/22)and 25.00%(6/24)of cases in the conventional group and in the CO_(2) laser group,respectively(P=0.01).Conclusion:Although the audiological outcomes with fiber‐enabled CO_(2) laser in endoscopic stapedotomy are comparable to conventional surgery,it is a better tool in a narrow auditory canal,requiring minimal manipulation of the chorda tympani nerve.
