Color Atlas of EndoOtoscopy Examination Diagnosis Treatment

Despite the many advances in diagnostic technologies and imaging modalities in recent years, otoscopy remains the first diagnostic option in the diagnosis of otologic disease. This is an easytoconsult book for residents and specialists, featuring brilliant diagnostic images from the newest generation of endoscopic otoscopes. Written by a renowned team of experts with 30 years of experience, this book helps readers obtain proficiency in otoscopy and in the interpretation of findings. Readers will learn what clinical consequences the diagnoses may have through case examples and treatment suggestions.

Color At las of Endo-Ot oscopy Exam inat ion–Diagnosis–Treat m ent Mar io San n a, MD Professor of Otolar yngology Depart m en t of Head an d Neck Surger y Un iversit y of Ch ieti Ch ieti, Italy Director Gruppo Otologico Piacen za an d Rom e, Italy Alessan d Ru sso, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy An ton io Car u so, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Abd elkad er Taibah , MD Neurosurgeon , Otologist , an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Gian lu ca Piras, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Wit h t h e collaborat ion of Fern an Man cin i, Hirosh i Sun ose, En rico Piccirillo, Loren zo Lauda, An n alisa Gian n uzzi, Sam path Ch an dra Prasad Rao 1007 illust ration s Th iem e Stuttgart • New York • Delh i • Rio de Jan eiro Librar y of Con gress Cat alogin g-in -Pu blicat ion Dat a is available from th e publish er Im p or t an t n ote: Medicin e is an ever-ch an ging scien ce un dergoing tin ual developm en t Research an d clinical experien ce are tin ually expan ding our kn ow ledge, in particular our kn ow ledge of proper treatm en t an d drug th erapy In sofar as th is book m en tion s any dosage or application , readers m ay rest assured th at th e auth ors, editors, an d publish ers h ave m ade ever y effort to en sure th at such referen ces are in accordan ce w ith t h e st ate of k n ow ledge at t h e t im e of p rod u ct ion of t h e book Neverth eless, th is does n ot involve, im ply, or express any guaran tee or respon sibilit y on th e part of th e publish ers in respect to any dosage in struct ion s an d form s of application s stated in th e book Ever y u ser is requ ested t o exam in e car efu lly th e m an ufacturers’ lea ets accom panying each drug an d to ch eck, if n ecessar y in sultation w ith a physician or specialist, w h eth er th e dosage sch edules m en tion ed th erein or th e train dicat ion s stated by th e m an ufacturers differ from th e statem ents m ade in th e presen t book Such exam in ation is particularly im por tan t w ith drugs th at are eith er rarely used or h ave been n ew ly released on th e m arket Ever y dosage schedule or ever y form of application used is en tirely at th e user’s ow n risk an d respon sibilit y Th e auth ors an d publish ers request ever y user to report to th e publish ers any discrepan cies or in accuracies n oticed If errors in th is w ork are foun d after publication , errata w ill be posted at w w w th iem e.com on th e product description page Som e of th e product n am es, paten ts, an d registered design s referred to in th is book are in fact registered tradem arks or proprietar y n am es even th ough speci c referen ce to th is fact is n ot alw ays m ade in th e text Th erefore, th e appearan ce of a n am e w ith out design ation as proprietary is n ot to be strued as a represen tation by th e publish er th at it is in th e public dom ain © 2017 by Georg Th iem e Verlag KG Th iem e Publish ers Stuttgart Rüdigerstrasse 14, 70469 Stut tgart, Germ any +49 [0]711 8931 421, custom erservice@th iem e.de Th iem e Publish ers New York 333 Seven th Aven ue, New York, NY 10001 USA +1 800 782 3488, custom erservice@th iem e.com Th iem e Publish ers Delh i A-12, Secon d Floor, Sector-2, Noida-201301 Uttar Pradesh , In dia +91 120 45 566 00, custom erser vice@th iem e.in Th iem e Publish ers Rio de Jan eiro, Th iem e Publicaỗừes Ltda Edifớcio Rodolph o de Paoli, 25 an dar Av Nilo Peỗan h a, 50 Sala 2508 Rio de Jan eiro 20020-906 Brasil Tel: +55 21 3172-2297 / +55 21 3172-1896 Cover design : Th iem e Publish ing Group Typesettin g by DiTech Process Solution s, In dia Prin ted in In dia by Replika Press Pvt Ltd ISBN 978-3-13-241523-2 Also available as an e-book: eISBN 978-3-13-241524-9 54321 Th is book, in cludin g all parts th ereof, is legally protected by copyrigh t Any use, exploitation , or com m ercialization outside th e n arrow lim its set by copyrigh t legislation w ith out th e publish er’s consen t is illegal an d liable to prosecution Th is applies in particular to ph otostat reproduct ion , copying, m im eograph ing or duplication of any kin d, tran slatin g, preparation of m icro lm s, an d elect ron ic data processing an d storage Cont ent s Preface vii Cont ribut ors viii Met hods of Ot oscopy The Norm al Tym panic Mem brane 2.1 Anat om y 2.2 Hist ology 11 Diseases A ect ing t he Ext ernal Audit ory Canal 13 3.1 Exost osis and Ost eom as 14 3.1.1 Surger y for Exostosis an d Osteom a: Can alplast y 21 3.2 Ext ernal Audit ory Canal Inflam m at ory Diseases 25 3.2.1 3.2.2 3.2.3 3.2.4 3.2.5 3.2.6 Eczem a Otitis Extern a Forun colosis Otom ycosis Myringit is an d Meatal Sten osis Surger y for Postin flam m ator y Sten osis of th e Extern al Auditory Can al 25 25 27 27 29 33 2.3 Physiology 11 3.4 Pat hologies Ext ending t o t he Ext ernal Audit ory Canal 40 3.4.1 3.4.2 3.4.3 3.4.4 3.4.5 3.4.6 Carcin oid Tum ors Histiocytosis X Men ingiom as Facial Nerve Tum ors Low er Cran ial Nerves Schw an n om a Oth er Path ologies 3.5 Tem poral Bone Fract ures 49 3.6 Carcinom a of t he Ext ernal Audit ory Canal 50 40 41 42 44 46 47 3.3 Cholest eat om a of t he Ext ernal Audit ory Canal 37 Ot it is Media 65 4.1 Secret ory Ot it is Media (Ot it is Media w it h E usion) 66 4.2 Secretory Otitis Media Secondary t o Neoplasm 69 Cholest erol Granulom a 75 At elect asis, Adhesive Ot it is Media 81 Noncholest eat om at ous Chronic Ot it is Media 93 7.1 General Charact erist ics of Tym panic Mem brane Perforat ions 94 7.7 Perforat ions Com plicat ed or Associat ed w it h Ot her Pat hologies 104 7.2 Post erior Perforat ions 94 7.8 Tym panosclerosis 107 7.8.1 7.8.2 Tym pan osclerosis Associated w ith Tym pan ic Mem bran e Perforation 107 Tym pan osclerosis w ith Intact Tym panic Mem brane 110 7.9 Principles of Myringoplast y 112 7.3 Ant erior Perforat ions 97 4.3 Acut e Ot it is Media 74 7.4 Inferior Perforat ions 99 7.5 Subt ot al and Tot al Perforat ions 100 7.6 Post t raum at ic Perforat ions 102 Chronic Suppurat ive Ot it is Media w it h Cholest eat om a 117 8.1 Epit ym panic Ret ract ion Pocket 118 8.2 Epit ym panic Cholest eat om a 120 v Contents 8.3 Mesot ym panic Cholest eat om a 129 8.6 Surgical Treat m ent of Cholest eat om a: Individualized Technique 139 8.4 Cholest eat om a Associat ed w it h At elect asis 134 8.6.1 8.6.2 8.6.3 Can al Wall Up (Closed) Tym pan oplast y 139 Can al Wall Dow n (Closed) Tym pan oplast y 145 Modified Bon dy’s Techn ique 153 8.5 Cholest e at om a Associat ed w it h Com plicat ions 136 Congenit al Cholest eat om a of t he Middle Ear 159 10 Pet rous Bone Cholest eat om a 167 10.1 Surgical Managem ent 184 10.1.2 Problem s in Surger y 193 10.1.1 Th e Tran sotic an d Modified Tran scoch lear Approaches 184 11 Tem poral Bone Paragangliom as 195 11.1 Clinical Present at ion of Tym panic and Tym panom ast oid Paragangliom as 197 11.5.1 Surgical Man agem en t 208 Clinical Present at ion of Tym panojugular Paragangliom as 197 11.6.1 Surgical Man agem en t 218 11.2 11.3 Im aging Charact erist ics 197 11.6 11.7 Class B: Tym panom ast oid Paragangliom as 213 Class C: Tym panojugular Paragangliom as 221 11.7.1 Surgical Man agem en t 236 11.3.1 Tym pan ojugular Paragan gliom as 197 11.8 11.4 Classificat ion: The Modified Fisch Classificat ion Syst em for TJP 198 11.8.1 Surgical Techn ique 237 11.5 Class A: Tym panic Paragangliom as 205 12 Rare Ret rot ym panic Masses 241 12.1 Di erent ial Diagnosis of Ret rot ym panic Masses 242 12.2 12.3 Type A Infrat em poral Fossa Approach 237 12.5 Facial Nerve Tum ors 250 12.6 Aberrant Carot id Art ery 260 12.7 Int ernal Carot id Art ery Aneurysm 261 12.8 High Jugular Bulb 262 Meningiom a 242 Low er Cranial Nerves Neurinom a 247 12.4 Chondrosarcom a of t he Jugular Foram en 249 13 Meningoencephalic Herniat ion 267 13.1 Surgical Managem ent 276 13.1.1 Tran sm astoid Approach 276 13.1.2 Tran sm astoid Approach w ith Min icran iotom y 278 13.1.3 Subtotal Petrosectom y 279 14 Post surgical Condit ions 285 14.1 Myringot om y and Insert ion of Vent ilat ion Tube 286 14.2 St apes Surgery 290 14.3 Myringoplast y 293 14.3.1 Failures an d Com plication s 297 14.4 Tym panoplast y 301 14.4.1 Can al Wall Up (Closed) Tym pan oplast y 301 14.4.2 Can al Wall Dow n (Open ) Tym pan oplast y 316 14.4.3 Meatoplast y, Blin d-Sac Closure of th e Extern al Auditory Can al 327 14.5 Hearing Im plant s 329 References 331 Index 337 vi Preface Despite advan ces in diagn ostic tech n iques an d im aging m odalit ies, otoscopy rem ain s th e corn erston e in th e diagn osis of otologic diseases Ever y otolar yngologist, pediatrician , or even gen eral practition er dealin g w ith ear diseases sh ould h ave a good kn ow ledge of otoscopy Th is atlas is based on 30 years of experien ce in Gruppo Otologico in th e t reatm en t of otologic an d n eurotologic disorders, w ith m ore th an 32,000 surgical operation s an d 300,000 sultation s It presen ts a vast collect ion of otoscopic view s of a variety of lesion s th at can affect th e ear an d tem poral bon e Many exam ples are given for each disease so th at th e reader becom es acquain ted w ith th e variable presen tation s each path ology can h ave W h ile otoscopy alon e can establish th e diagn osis in som e cases, param eters such as h istory or audiological an d n euroradiological evaluation are required in oth ers An im portan t aspect of th is atlas is th at it ju xtaposes, w h en appropriate, th e clin ical picture, radiological diagn osis, an d in t raoperative n din gs w ith th e otoscopic n din gs of th e patien t Needless to say, ever y patien t sh ould be sidered as a w h ole, an d in som e particular cases, th e otoscopic n din gs m igh t on ly be th e “tip of th e iceberg.” Otalgia, otorrh ea, an d gran ulation s in th e extern al auditory can al are m an ifestation s of otit is extern a, but w h en th ey persist, particularly in th e elderly, th ey sh ould arouse suspicion of m align an cy Ot itis m edia w ith effu sion can be a sim ple disease w h en seen in ch ildren , w h ereas un ilateral persisten t otitis m edia w ith effusion in an adult m ay be th e on ly sign of a n asoph ar yn geal carcin om a A sm all att ic perforation in th e presen ce of facial n er ve paralysis an d sen sorin eural h earin g loss m ay be all th at is seen in a gian t petrous bon e ch olesteatom a Th e m an ifestation of an aural polyp can var y from a m ucosal polyp associated w ith ch ron ic suppurative otitis m edia to th e m uch less com m on but m ore dan gerous tem poral bon e paragangliom a A sm all retrot ym pan ic m ass m ay represen t an an om alous an atom y such as a h igh jugular bulb or an aberran t carotid arter y It m ay also represen t fran k path ology such as facial n er ve n eurom a, gen ital ch olesteatom a, or even en -plaque m en in giom a In each ch apter, a surgical sum m ar y th at lists th e differen t approaches for th e m an agem en t of th e path ology dealt w ith is provided Th rough out th e book, em ph asis is on h ow th e otoscopic view an d th e clin ical pict ure m ay affect th e ch oice of treatm en t an d th e surgical tech n ique At th e en d of th is atlas, a ch apter on postsurgical dition s is presen ted Th e presen ce of previous surger y poses special dif culties because of th e distorted an atom y Moreover, th e otologist sh ould be able to distin guish bet w een w h at is sidered to be n orm al postsurgical h ealin g an d com plicat ion s th at n eed furth er in ter ven t ion Our goal is to offer an easy-to-con sult book for residen ts, specialists, an d gen eral pract ition ers So, th is rst-step approach to patien ts w ith otologic diseases can open a w ider view on com plete kn ow ledge of otology, n eurotology, skull base path ology an d surger y, an d n euroradiology Drs Russo, Taibah , Caruso, an d Gian luca Piras, a n ew young colleague w h o h as been w orkin g w ith us for th e past year, h elped to accom plish th is w ork w ith th eir act ive an d en th usiastic participation A special th an k goes to th e oth er m em bers of Gruppo Otologico, for th eir tribut ion in th e realization of th is book: Drs Piccirillo, Lauda, Gian n uzzi, an d Prasad Th e auth ors w ould like to th an k Mr Steph an Kon n r y at Th iem e Publish ers for h is excellen t cooperat ion an d h elp Th an ks also go to Paolo Piazza, n euroradiologist , for h is t in uous cooperat ion an d to Fern an Man cin i for th e illustration s in cluded in th e book Ma r io Sa nna , MD vii Cont ribut ors An t on io Car u so, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Sam p at h Ch an d Prasad Rao, MS, DNB, FEB-ORLHNS ENT an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy An n alisa Gian n u zzi, MD, Ph D Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Alessan d Ru sso, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Loren zo Lau d a, MD ENT an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Mar io San n a, MD Professor of Otolaryn gology Depart m en t of Head an d Neck Surgery Un iversit y of Ch ieti Ch ieti, Italy Director Gruppo Otologico Piacen za an d Rom e, Italy Fer n an d o Man cin i, MD ENT an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy viii En r ico Piccir illo, MD ENT an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Hirosh i Su n ose Depart m en t of Otolaryn gology Medical Cen ter East Tokyo Wom en’s Medical Un iversit y Tokyo, Japan Gian lu ca Piras, MD Otologist an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Abd elkad er Taibah , MD Neurosurgeon , Otologist , an d Skull Base Surgeon Gruppo Otologico Piacen za an d Rom e, Italy Postsurgical Conditions 326 Fig 14.150 Left ear TORP in extrusion following a second- stage open t ym panoplast y In the first stage, a cholesteatoma involving the attic and mesot ympanum and causing erosion of the ossicular chain was removed In the second stage, a TORP was used for reconstruction It was placed bet ween the footplate of the stapes and the t ympanic membrane One year postoperatively, early extrusion of the prosthesis is observed To avoid this complication, a tragal cartilage has to be placed between the prosthesis and the t ympanic membrane Fig 14.151 Right ear In this case of a modified Bondy’s technique, incus erosion occurred years postoperatively due to the presence of a significant retraction pocket The middle ear shows a catarrhal effusion Fig 14.152 Right ear A modified Bondy’s technique Two cholesteatomatous pearls are present in the cavit y They are easily removed in the outpatient clinic The at tic, antrum, and mastoid were exteriorized The ossicular chain was left in situ Fig 14.153 Left ear A cholesteatom atous pearl seen in the attic following a modified Bondy’s technique Postsurgical Conditions Fig 14.154 Sam e patient after removal of the pearl in the outpatient clinic Fig 14.155 Radical mastoidectomy A mucosal cyst causes complete obstruction of the external auditory canal 14.4.3 Meat oplast y, Blind-Sac Closure of t he Ext ernal Audit ory Canal Exam ples of m eatoplast y h ave been sh ow n in Fig 14.156, Fig 14.157, Fig 14.158, Fig 14.159, Fig 14.160 See extern al auditor y can al closure in Fig 14.161, Fig 14.162, Fig 14.163 Fig 14.156 The performance of an adequate meatoplast y that suits the dimension of the cavit y is fundamental to assure proper aeration and prevent accumulation of epithelial debris and cerumen in the cavit y 327 Postsurgical Conditions Fig 14.158 A well-performed large meatoplast y in an open t ympanoplasty, providing perfect aeration of the cavit y Fig 14.157 Another example of meatoplast y performed in an open t ym panoplast y Fig 14.159 Another example of a meatoplast y performed in a 10year-old boy who underwent surgery for bilateral epit ym panic cholesteatoma using a m odified Bondy’s technique 328 Fig 14.160 Example of a meatoplast y that shows stenosis Postsurgical Conditions Fig 14.161 Surgical picture of a blind-sac closure of the external auditory canal The skin is everted and sutured with absorbable stitches After some months, the closed wound tends to retract inside the external auditory canal with no aesthetic issues (see Fig 14.162) Fig 14.162 Image of the same patient months after surgery The wound is com pletely closed and the skin infolded inside the external auditory canal Fig 14.163 CT scan, axial view, of the surgical cavit y (obliterated with abdominal fat) The external auditory canal is blind-sac closed (arrow) 14.5 Hearing Im plant s Hearin g im plan tology is a set of surgical tech n iques aided by devices aim ed at th e fun ction al reh abilitation of a patien t a ected by total or partial deafn ess Hearin g im plan ts are n ot a replacem en t for an ear, but th ey can h elp m any people w h o w ere e ectively declared deaf By st im ulating th e auditory n er ve, sign als are tran sm it ted to th e brain , w h ich turn s in to “h earin g.” Im plants are key for m any ch ildren or in fan ts born w ith severe h earin g loss w h o receive th e devices so th at th ey can grow up w ith auditor y skills an d h ave st ron ger lan guage skills A cochlear im plant (CI) is a surgically im planted electronic device that provides a sense of sound to a person w ho is profoundly deaf or severely hard of hearing CI m ay help provide hearing in patients w ho are deaf because of dam age to sensory hair cells in their cochleas In those patients, the im plants often can enable su cient hearing for better understanding of speech Newer devices and processing strategies allow recipients to hear better in noise, enjoy m usic, and even use their im plant processors w hile sw im m ing An auditory brainstem im plant (ABI) is a surgically im planted electronic device that provides a sen se of sound to a person w h o is profoundly deaf due to sen sorin eural h earing im pairm en t (due to illn ess or injury dam aging the coch lea or auditory nerve, and so precluding the use of a CI) The ABI uses sim ilar tech nology as the CI, but in stead of electrical stim ulation being used to stim ulate the coch lea, it is used to stim ulate the brain stem of the recipien t Active m iddle ear im plants (Esteem Im plantable Hearing System , Vibrant Soundbridge Middle Ear Im plant System , Carina Implantable Hearing System ) are surgically im planted hearing aids, w hich are placed w ithin the m iddle ear, and are suggested as a therapy for certain patients w ith conductive, sensorineural, or m ixed hearing loss for w hom alternative treatm ents (e.g., conventional hearing aids, bone anchored hearing aids) are unsuitable Active m iddle ear im plants can be fully im plantable or sem i-im plantable and work via electrom agnetic or piezoelectric transducers A bon e-anch ored h earing im plant (BAHI) is a type of h earing aid based on bon e conduction It is prim arily suited to people w h o h ave conductive hearing losses, unilateral h earing loss, and m ixed h earing losses w h o can not otherw ise wear “in the ear” or “beh in d the ear” hearing aids A patien t w ithout extern al/m iddle 329 Postsurgical Conditions ear function is one exam ple w here a BAHI could be useful w here a conventional h earing aid w ith a m old in the ear canal open ing is n ot possible to use As the inn er ear is n orm al, sound conducted via th e skull bon e could give n orm al/n ear-norm al hearing 330 Exam ples of h earin g im plan tology h ave been sh ow n in Fig 14.164, Fig 14.165, Fig 14.166, Fig 14.167 Fig 14.164 Left ear Extrusion of a Vibrant Soundbridge Part of the Floating Mass Transducer (FMT) is outside the t ympanic membrane (arrow) Fig 14.165 Another example of extrusion of a Vibrant Soundbridge, placed at the same stage of a radical m astoidectomy for a recurrent cholesteatoma The cavit y is discharging and the conductor link with the FMT is extruded Hearing rehabilitation with implantable devices has been introduced since more than 50 years with cochlear im plants In case of discharging cavities or cholesteatoma, we prefer to stage the procedures and perform a subtotal petrosectomy, to be radical in disease clearance and avoid extrusion of the implant Fig 14.166 Right ear Otoscopy after cochlear implantation The electrode of the implant is inserted in the round window through a posterior tympanotomy, after having performed a closed mastoidectomy Fig 14.167 Left ear Extrusion of a cochlear implant The receiverstimulator is in contact with the skin of the posterior canal wall References References References Am en d ola S, Falcion i M, Caylan R, San n a M Recurren t ch olesteatom a in open vs closed tech nique t ym pan oplasties an d its surgical m an agem en t Proceedin gs of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Arìstegui M, Cokkeser Y, Saleh E, et al Surgical an atom y of th e extended m idd le cran ial fossa approach Skull Base Surg 1994; 4(4):181–188 Arìstegui M, Falcion i M, Saleh E, et al Men in goen ceph alic h ern iation in to th e m iddle ear: a report of 27 cases Lar yn goscope 1995; 105(5, Pt 1):512–518 An n Otol Rh in ol Lar yn gol 1965; 74(3):706–727 Dich iro G, Fish er RL, Nelson KB Th e jugular foram en J Neurosurg 1964; 21:447– 460 Don aldson A, Duckert LG, Lam ber t PM, Rubel EW An son an d Don aldson Surgical An atom y of th e Tem poral Bon e New York, NY: Raven Press; 1992 Dort JC, Fisch U Facial n er ve sch w an n om as Skull Base Surg 1991; 1(1):51–56 Falcion i M, De Don ato G, Lan dolfi M, et al Th e m od ified Bon dy tech n ique in th e Aust in DF Th e sign ifican ce of th e retraction pockets in th e treatm en t of ch olestea- treatm en t of epit ym pan ic ch olesteatom a Proceedings of th e Fifth In tern ation al tom a In : McCabe BF, Sadè J, Abram son M, eds Ch olesteatom a: First In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surgery; Algh ero-Sardin ia, Italy; Sep - Con feren ce Birm in gh am , AL: Aesculapius; 1977:379–383 tem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Bacciu A, Clem en te IA, Piccirillo E, Ferrari S, San n a M Gu idelin es for treatin g tem po- Falcion i M, San n a M Usefuln ess of preoperative im aging in ch ron ic ear surgery Pro- ral bon e carcin om a based on lon g-term outcom es Otol Neurotol 2013; 34 ceedings of th e Sixth In tern ation al Con feren ce on Ch olesteatom a an d Ear Sur- (5):898–907 gery; Can n es, Fran ce, Jun e 29–July 2, 2000 Label Production Bacciu A, Nusier A, Lauda L, Falcion i M, Russo A, San n a M Are th e curren t treatm en t Falcion i M, Frisin a A, Taibah A, Piccirillo E, De Don ato G, Man cin i F Surgical t reat- strategies for facial n er ve sch w an n om a appropriate also for com plex cases? m en t of labyrin th in e fistula in ch ron ic ear surgery Proceedin gs of th e Sixth In ter- Audiol Neurootol 2013; 18(3):184–191 n ation al Con feren ce on Ch olesteatom a an d Ear Surgery; Can n es, Fran ce, Jun e 29– Bacciu A, Ait Mim oun e H, D’Orazio F, Vit ullo F, Russo A, San n a M Man agem en t of July 2, 2000 Label Production facial n er ve in surgical treatm en t of previously un treated fisch class C t ym pan o- Falcion i M, Caruso A, Avan zin i P, Piccion i L, Russo A Facial n er ve iatrogen ic palsy in jugular paragangliom as: lon g-term results J Neurol Surg B Skull Base 2014; 75 ch ron ic ear surgery Proceedin gs of th e Sixth In tern ation al Con feren ce on Ch oles- (1):1–7 teatom a an d Ear Surger y; Can n es, Fran ce, Jun e 29–July 2, 2000 Label Production Bacciu A, Medin a M, Ait Mim oun e H, et al Low er cran ial n er ves fun ct ion after surgical treatm en t of Fisch Class C an d D t ym pan ojugular paragan gliom as Eur Arch Otorh in olar yn gol 2015; 272(2):311–319 Balyan FR, Celikkan at S, Aslan A, Taibah A, Russo A, San n a M Mastoidectom y in n on ch olesteatom atous ch ron ic suppurative otitis m edia: is it n ecessary? Otolaryn gol Head Neck Surg 1997; 117(6):592–595 Bh atia S, Karm arkar S, DeDon ato G, et al Can al w all dow n m astoidectom y: causes of failure, pitfalls an d th eir m an agem en t J Lar yn gol Otol 1995; 109(7):583–589 Brackm an n DE, Sh elton C, Arriaga MA 1994 Cam a A, Vergin elli F, Lott i LV, et al In tegrative gen etic, epigen et ic an d path ological an alysis of paragangliom a reveals com plex dysregulation of NOTCH sign alin g Acta Neuropath ol 2013; 126(4):575–594 Caparosa R An Atlas of Surgical An atom y an d Tech n iques of th e Tem poral Bon e Sprin gfield, IL: Th om as; 1972 Caylan R, Tit iz A, De Don ato G, et al Meatoplasty tech n ique in can al w all dow n procedures Proceedin gs of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Celikkan at SM, Saleh E, Kh ash aba A, et al Cerebrospin al fluid leak after tran slabyrin th in e acoustic n eurom a surger y Otolar yn gol Head Neck Surg 1995; 112 (6):654–658 Ch arach on R La t ym pan oplastie Gren oble: Presses Un iversitaires; 1990 Ch arach on R, Roulleau P, Brem on d G, et al 1987 Ch ole RA Petrous apicit is: surgical an atom y An n Otol Rh in ol Laryn gol 1985; 94 (3):251–257 Cody DTR, Taylor W Mastoidectom y for acquired ch olesteatom a: lon g-term results In : McCabe BF, Sadè J, Abram son M, eds Ch olesteatom a: First In tern ation al Con feren ce Birm in gh am , AL: Aesculapius; 1977;337–351 Coh en D Location s of prim ar y ch olesteatom a Am J Otol 1987; 8(1):61–65 Coker NJ, Jen kin s HA, Fisch U Obliteration of th e m idd le ear an d m astoid cleft in subtotal petrosectom y: in dication s, tech n ique, an d results An n Otol Rh in ol Laryn gol 1986; 95(1, Pt 1):5–11 Cokkeser Y, Naguib M, Aristegui M, et al Revision stapes surgery: a crit ical evaluation Otolar yn gol Head Neck Surg 1994; 111(4):473–477 Cokkeser Y, Aristegui M, Naguib M, Saleh E, San n a M Surgical an atom y of th e vertebral artery at th e cran iover tebral jun ction In : Mazzon i A, San n a M, eds Skull Base Surgery Update Vol Am sterdam : Kugler; 1995;43–48 De Don ato G, Caylan R, Falcion i M, et al Facial n er ve m an agem en t an d results in petrous bon e ch olesteatom a surger y Proceedings of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Deguin e C Lon gterm results in ch olesteatom a surgery Clin Otolaryn gol Allied Sci 1978; 3(3):301–310 De la Cruz A Th e tran scoch lear approach to m en in giom as an d ch olesteatom a of th e cerebellopon t in e an gle In : Brackm an n DE, ed Neurological Surger y of th e Ear an d Skull Base New York, NY: Raven Press; 1982:353–360 332 Derlacki EL, Clem is JD Con gen ital ch olesteatom a of th e m iddle ear an d m astoid Falcion i M, Russo A, Taibah A, San n a M Facial n er ve t um ors Otol Neurotol 2003; 24 (6):942–947 Farrior JB An terior facial n er ve decom pression Otolaryn gol Head Neck Surg 1985; 93(6):765–768 Farrior JB Th e can al w all in t ym pan oplast y an d m astoidectom y Arch Otolaryn gol 1969; 90(6):706–714 Farrior JB System atized approach to surgery for ch olesteatom a Arch Otolaryn gol 1973; 97(2):188–190 Fisch U In fratem poral fossa approach to tum ours of th e tem poral bon e an d base of th e skull J Lar yn gol Otol 1978; 92(11):949–967 Fisch U In fratem poral fossa approach for glom us t um ors of th e tem poral bon e An n Otol Rh in ol Lar yn gol 1982; 91(5, Pt 1):474–479 Fisch U Th e in fratem poral fossa app roach for n asoph ar yn geal tum ors Laryn goscope 1983; 93(1):36–44 Fisch U Tym pan oplast y, Mastoidectom y, an d Stapes Surger y Stut tgart: Th iem e; 1994 Fisch U, Esslen E Total in t ratem poral exposure of th e facial n er ve Path ologic fin din gs in Bell’s palsy Arch Otolar yn gol 1972; 95(4):335–341 Fisch U, Mattox D Microsurgery of th e Skull Base New York, NY: Th iem e; 1988 Fisch U, Fagan P, Valavan is A Th e in fratem poral fossa approach for th e lateral skull base Otolar yn gol Clin North Am 1984; 17(3):513–552 Flood LM, Kem in k JL Surger y in lesion s of th e petrous apex Otolar yn gol Clin North Am 1984; 17(3):565–575 Fried berg J Con gen ital ch olesteatom a Lar yn goscope 1994; 104(3, Pt 2) Suppl:1–24 Gam oletti R, Bellom i A, San n a M, Zin i C, Scan dellari R Histology of extruded PlastiPore ossicular prosth eses Otolaryn gol Head Neck Surg 1984; 92(3):342–345 Gacek RR Surgical lan dm ark for th e facial n er ve in th e epit ym pan um An n Otol Rh in ol Lar yn gol 1980; 89(3, Pt 1):249–250 Gan tz BJ, Fisch U Modified t ran sotic app roach to th e cerebellopon tile an gle Arch Otolaryn gol 1983; 109(4):252–256 Glasscock ME, III Surgical tech n ique for open m astoid procedures Lar yn goscope 1982; 92(12):1440–1442 Glasscock ME, III, Harris PF, New som e G Glom us t um ors: diagn osis an d t reatm en t Lar yn goscope 1974; 84(11):2006–2032 Glasscock ME, Miller GW In tact can al w all t ym pan oplast y in th e m an agem en t of ch olesteatom a Lar yn goscope 1976; 86(11):1639–1657 Glasscock ME, Sh am baugh GE Surger y of th e Ear 4th ed Ph iladelph ia, PA: Saun ders; 1990 Goodh ill V Tragal perich on drium an d cartilage in t ym pan oplast y Arch Otolar yn gol 1967; 85(5):480–491 Guild SR A h ith er to un recogn ized st ructure, th e glom us jugularis in m an An at Rec 1941; 79((Suppl 2)):28 Guild SR Th e glom us jugulare, a n on ch rom a n ol Lar yn gol 1953; 62(4):1045–1071 n paragan glion , in m an An n Otol Rh i- References Hakuba A, Nish im ura S, Jan g BJ A com bin ed retroauricular an d preauricular t ran spetrosal-t ran sten torial approach to clivus m en in giom as Surg Neurol 1988; 30 (2):108–116 Ho m an RA Cerebrospin al fluid leak follow in g acoustic n eurom a rem oval Lar yn goscope 1994; 104(1, Pt 1):40–58 House WF Surgical exposure of th e in tern al auditor y can al an d its ten ts th rough th e m iddle, cran ial fossa Lar yn goscope 1961; 71:1363–1385 House WF Mid dle cran ial fossa approach to th e petrous pyram id: report of 50 cases Arch Otolar yn gol 1963; 78:460–469 House WF, Hitselberger WE Tran stem poral bon e m icrosurgical rem oval of acoustic n eurom as: total versus subtotal rem oval of acoustic tum ors Arch Otolar yn gol 1964;80:751–752 House WF, Sh eehy JL Fun ct ion al restorat ion in t ym pan oplast y Arch Otolar yn gol 1963; 78:304–309 House WF, Glasscock ME, III Glom us t ym pan icum tum ors Arch Otolaryn gol 1968; 87(5):550–554 House WF, Hitselberger WE Th e t ran scoch lear approach to th e skull base Arch Otolar yn gol 1976; 102(6):334–342 House JL, Hitselberger WE, House WF Woun d closure an d cerebrospin al fluid leak after tran slabyrin th in e su rgery Am J Otol 1982; 4(2):126–128 House JW , Brackm an n DE Facial n er ve gradin g system Otolaryn gol Head Neck Surg 1985; 93(2):146–147 Jackler RK Over view of surgical n euro-otology In : Jackler RK, Brackm an n DE, eds Neuro-otology Baltim ore, MD: Mosby; 1993;651–684 Jackson CG Surger y of Skull Base Tum ors New York, NY: Ch urch ill Livin gston e; 1991 Jackson CG, Glasscock ME, III, McKen n an KX, et al Th e surgical treatm en t of skullbase t um ors w ith in tracran ial exten sion Otolaryn gol Head Neck Surg 1987; 96 (2):175–185 Jackson CG, Cueva RA, Th edin ger BA, Glasscock ME, III Con ser vation surger y for glom us jugulare tum ors: th e value of early diagn osis Lar yn goscope 1990; 100(10, Pt 1):1031–1036 Jan sen C Th e com bin ed approach for t ym pan oplast y (report on 10 years’ experien ce) J Lar yn gol Otol 1968; 82(9):779–793 Jan sen C Posterior t ym pan otom y: experien ces an d surgical details Otolar yn gol Clin North Am 1972; 5(1):79–96 Jan sen C In tact can al w all t ym pan oplast y In : Sh am baugh G, Sh ea J, eds Fifth In tern ation al Worksh op on Middle Ear Microsurger y Hun tsville, AL: Strode; 1977:370–375 Jen kin s HA, Fisch U Glom us t um ors of th e tem poral region Tech n ique of surgical resect ion Arch Otolar yn gol 1981; 107(4):209–214 Karm arkar S, Bh atia S, Saleh E, et al Ch olesteatom a surgery: th e in dividualized tech n ique An n Otol Rh in ol Lar yn gol 1995; 104(8):591–595 Karm arkar S, Bh atia S, Kh ash aba A, Saleh E, Russo A, San n a M Con gen ital ch olesteatom as of th e m iddle ear: a di eren t experien ce Am J Otol 1996; 17(2):288–292 Krm potic-Nem an ic J, Draf W , Helm s J Surgical An atom y of th e Head an d Neck Berlin : Sprin ger; 1985 Kveton JF, Cooper MH Microsurgical an atom y of th e jugular foram en region Am J Otol 1988; 9(2):109–112 Lan dolfi M, Taibah A, Russo A, Szym an ski M, Sh aan M, San n a M Revalidation of th e Bon dy tech n ique In : Nakan o Y, ed Ch olesteatom a an d Mastoid Surgery Am sterdam : Kugler; 1993:719–721 Lan g J Topograph ical an atom y of th e skull base an d adjacen t tissues In : Sch eun em an n H, Sch urm an n K, Helm s J, eds Tum ors of th e Skull Base Berlin : de Gruyter; 1986:3–28 Lau T, Tos M Treatm en t of sin us ch olesteatom a Lon g-term results an d recurren ce rate Arch Otolaryn gol Head Neck Surg 1988a; 114(12):1428–1434 Lau T, Tos M Sin us ch olesteatom as: Recurren cies an d observation t im e Acta Otolaryn gol 1988b; 105 suppl 449:191–193 Lau T, Tos M Ten sa retraction ch olesteatom a: t reatm en t an d lon g-term results J Lar yn gol Otol 1989; 103(2):149–157 Levenson MJ, Mich aels L, Parisier SC Con gen ital ch olesteatom as of th e m idd le ear in ch ildren : origin an d m an agem en t Otolar yn gol Clin North Am 1989; 22(5):941– 954 Magn an J, Brém on d G Les dit ion s de guérison de l’otite ch ron ique ch olestéatom ateuse An n Otolar yn gol Ch ir Cer vicofac 1985; 102(8):565–573 Magn an J, Ch ays A, Gign ac D, Brem on d G Recon struction of posterior can al w all: lon g-term results In : Ch arach on R, Garcia- Iban ez E, eds Lon g-Term Results an d In dication s in Otology an d Oton eurosurger y Am sterdam : Kugler; 1991:57–61 Magn an J, San n a M En doscopy in Neuro-otology St uttgart: Th iem e; 1999 Man cin i F, Taibah AK, Falcion i M Com plication s an d th eir m an agem en t in t ym pan om astoid su rgery Otolaryn gol Clin North Am 1999; 32(3):567–583 Marquet J Eradication of ch olesteatom a In : Tos M, Th om sen J, Peitersen E, eds Ch olesteatom a an d Mastoid Surgery Am sterdam : Kugler; 1989: 811–816 Mar tin C, Prades JM Rem oval of selected in fralabyrin th in e lesion s w ith out facial n er ve m obilization Skull Base Surg 1992; 2(4):220–226 May M Total facial n er ve exploration : t ran sm astoid, extralabyrin th in e, an d subtem poral in dication s an d results Lar yn goscope 1979; 89(6, Pt 1):906–917 Mazzon i A In tern al auditor y can al arterial relation s at th e porus acust icus An n Otol Rh in ol Lar yn gol 1969; 78(4):797–814 Mazzon i A In tern al aud itory ar tery supply to th e petrous bon e An n Otol Rh in ol Laryn gol 1972; 81(1):13–21 Mazzon i A Jugulo-petrosectom y Arch Ital Ot yol Rh in ol Larin g 1974; 2:20–35 Mazzon i A, San n a M Th e petro-occipital t ran s-sigm oid approach to th e posterolateral skull base: results an d in dication s Paper presen ted at th e Th ird An n ual Meetin g of th e North Am erican Skull Base Societ y; Acapulco, Mexico; Februar y 15–20, 1992 Medin a M, Prasad SC, Patn aik U, et al Th e e ects of t ym pan om astoid paragangliom as on h earin g an d th e audiological outcom es after surgery over a lon g-term follow -up Audiol Neurootol 2014; 19(5):342–350 Mich aels L An epiderm oid form ation in th e developin g m iddle ear: possible source of ch olesteatom a J Otolaryn gol 1986; 15(3):169–174 Morim itsu T, Nagai T, Nagai M, et al Pathogen esis of ch olesteatom a based on clin ical results of an terior t ym pan otom y Auris Nasus Lar yn x 1989; 16 Suppl 1:S9–S14 Nadol JB, Jr Causes of failure of m astoidectom y for ch ron ic otitis m edia Lar yn goscope 1985; 95(4):410–413 Nager GT Path ology of th e Ear an d Tem poral Bon e Baltim ore, MD: William s an d Wilkin s; 1993 Naguib MB, Aristegui M, Saleh E, et al Surgical an atom y of th e petrous apex as it relates to th e en larged m iddle cran ial fossa app roach es Otolar yn gol Head Neck Surg 1994; 111(4):488–493 Naguib MB, Aristegui M, Saleh E, Cokkeser Y, Russo A, San n a M Surgical m an agem en t of epit ym pan ic ch olesteatom a w ith in tact ossicular ch ain : th e m odified Bon dy tech n ique Otolar yn gol Head Neck Surg 1994; 111(5):545–549 Nakan o Y Ch olesteatom a surger y an d m astoid obliterat ion In : Nakan o Y, ed Ch olesteatom a an d Mastoid Surgery Am sterdam : Kugler; 1993:769–773 Neely JG, Alford BR Facial n er ve n eurom as Arch Otolaryn gol 1974; 100(4):298– 301 Om ran A, De Den ato G, Piccirillo E, Leon e O, San n a M Petrous bon e ch olesteatom a: m an agem en t an d outcom es Lar yn goscope 2006; 116(4):619–626 Palva T Recon struction of ear can al an d m idd le ear in ch ron ic otitis Acta Otolaryn gol Suppl 1964; 188 suppl:188–, 228 Palva T, Mäkin en J Th e m eatally based m usculop eriosteal flap in cavit y obliteration Arch Otolaryn gol 1979; 105(7):377–380 Palva T, Palva A, Kärjä J Cavit y obliteration an d ear can al size Arch Otolar yn gol 1970; 92(4):366–371 Pan dya Y, Piccirillo E, Man cin i F, San n a M Man agem en t of com plex cases of petrous bon e ch olesteatom a An n Otol Rh in ol Lar yn gol 2010; 119(8):514–525 Paparella MM, Jun g TTK In tact bridge t ym pan om astoidectom y (I.B.M.)–com bin in g essen tial features of open vs closed procedures J Lar yn gol Otol 1983; 97 (7):579–585 Paparella MM, Jun g TTK In tact-bridge t ym pan om astoid ectom y Otolaryn gol Head Neck Surg 1984; 92(3):334–338 Paparella MM, Sh um rick DA Otolaryn gology Vols Ph iladelph ia, PA: Saun ders; 1988 Pellet W, Can n on i M, Pech A Th e w iden ed t ran scoch lear app roach to jugular foram en tum ors J Neurosurg 1988; 69(6):887–894 Piazza P, Di Lella F, Bacciu A, Di Trapan i G, Ait Mim ou n e H, San n a M Preoperative Liden -Jerger Tym pan oplast y-procedures, in terpretation an d variables In : Feldm an protective sten tin g of th e in tern al carotid artery in th e m an agem en t of com plex AS, Wilber LA, eds Acoust ic Im pedan ce an d Adm ittan ce—Th e Measurem en t of h ead an d n eck paragangliom as: lon g-term results Audiol Neurootol 2013; 18 Middle Ear Fun ct ion Balt im ore, MD: William s an d Wilkin s; 1976:103–155 (6):345–352 Lope Ah m ad RA, Sivalin gam S, Kon ish i M, De Don ato G, San n a M On cologic out- Piccion i L, Piccirillo E, Falcion i M, De Don ato G, Russo A, Taibah AK Mid dle ear ch o- com e in surgical m an agem en t of jugular paragangliom a an d factors in fluen cin g lesteatom a in ch ildren Proceedings of th e Sixth In tern ation al Con feren ce on outcom es Head Neck 2013; 35(4):527–534 333 References Ch olesteatom a an d Ear Surger y; Can n es, Fran ce; Jun e 29–July 2, 2000 Label Production prosth eses Am J Otol 1981; 2(3):225–229 Plester D Tym pan ic m em bran e h om ografts in ear surgery Acta Otorh in olar yn gol Belg 1970; 24(1):34–37 San n a M, Mazzon i A Th e m od ified tran scoch lear approach to th e t um ors of th e petroclival area an d prepon t in e cistern Paper presen ted at th e Th ird An n ual Meet- Portm an n M Th e Ear an d Tem poral Bon e New York, NY: Masson ; 1979 in g of th e North Am erican Skull Base Societ y; Acapulco, Mexico; Februar y 15–20, Prasad SC, Sh in SH, Russo A, Di Trapan i G, San n a M Curren t tren ds in th e m an age- 1992 m en t of th e com plication s of ch ron ic otit is m edia w ith ch olesteatom a Curr Opin Otolaryn gol Head Neck Surg 2013; 21(5):446–454 bon e m align an cies Curr Opin Otolar yn gol Head Neck Surg 2014; 22(2):154–165 Prasad SC, Mim oun e HA, D’Orazio F, et al Th e role of w ait-an d-scan an d th e e cacy of radioth erapy in th e treatm en t of tem poral bon e paragangliom as Otol Neurotol 2014; 35(5):922–931 Prasad SC, Mim oun e HA, Kh ardaly M, Piazza P, Russo A, San n a M St rategies an d lon g-term outcom es in th e surgical m an agem en t of t ym pan ojugular paragangliom as Head Neck 2016; 38(6):871–885 Prasad SC, Gian nuzzi A, Nah leh EA, Don ato G, Russo A, San n a M Is en doscopic ear surger y an altern ative to th e m odified Bon dy tech nique for lim ited epit ym pan ic ch olesteatom a? Eur Arch Otorh in olar yn gol 2016; 273(9):2533–2540 Proctor B Surgical an atom y of th e posterior t ym pan um An n Otol Rh in ol Lar yn gol 1969; 78(5):1026–1040 Proctor B Surgical An atom y of th e Ear an d Tem poral Bon e Stut tgart: Th iem e; 1989 Ram bo JHT A n ew operation to restore h earin g in duct ive deafn ess of ch ron ic suppu rative origin AMA Arch Otolaryn gol 1957; 66(5):525–532 Ram bo JHT Musculoplast y for restoration of h earin g in ch ron ic sup purative ears Arch Otolar yn gol 1969; 89(1):184–190 Rh oton AL, Jr, Buza R Microsurgical an atom y of th e jugular foram en J Neurosurg 1975; 42(5):541–550 Rh oton AL, Jr, Pulec JL, Hall GM, Boyd AS, Jr Absen ce of bon e over th e gen iculate gan glion J Neurosurg 1968; 28(1):48–53 Russo A, Taibah A, Lan dolfi M, et al Con gen ital ch olesteatom a Proceedin gs of th e Fourth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Niigata, Japan ; Septem ber 8–12, 1992 Am sterdam : Kugler Publicat ion s Russo A, Taibah AK, De Don ato G, Falcion i M, San n a M Con gen ital ch olesteatom as: A di eren t experien ce Proceedin gs of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Sadè J Postoperat ive ch olesteatom a recurren ce In : McCabe BF, Sadè J, Abram son M, eds Ch olesteatom a: First In tern ation al Con feren ce Birm in gh am , AL: Aesculapius; 1977:284–289 Sadè J Secretor y Ot itis Media an d Its Sequelae New York, NY: Ch urch ill Livin gston e; 1979 Saleh EA, Aristegui M, Taibah AK, Mazzon i A, San n a M Man agem en t of th e h igh jugular bulb in th e tran slabyrin th in e approach Otolar yn gol Head Neck Surg 1994a; 110(4):397–399 Saleh EA, Taibah AK, Ach illi V, Aristegui M, Mazzon i A, San n a M Posterior fossa m en in giom a: surgical st rategy Skull Base Surg 1994b; 4(4):202–212 Saleh E, Ach illi V, Naguib M, et al Facial n er ve n eurom as: diagn osis an d m an agem en t Am J Otol 1995a; 16(4):521–526 Saleh E, Naguib M, Aristegui M, Cokkeser Y, San n a M Low er skull base: an atom ic study w ith surgical im plication s An n Otol Rh in ol Lar yn gol 1995b; 104(1):57–61 Saleh E, Naguib M, Aristegui M, Cokkeser Y, Russo A, San n a M Surgical an atom y of th e jugular foram en area In : Mazzon i A, San n a M, eds Skull Base Surger y Update Vol Am sterdam : Kugler; 1995c:3–8 Sam ii M, Draf W Surgery of th e Skull Base Berlin : Sprin ger; 1989 San n a M An atom y of th e posterior m esotym pan um In : Zin i C, Sh eehy JL, San n a M, eds Microsurgery of Ch olesteatom a of th e Middle Ear Milan : Gh edin i; 1980:69– 73 Sann a M Ossicular ch ain recon st ruct ion in closed t ym pan oplasties In : Zin i C, Sh eehy JL, San n a M, eds Microsurger y of Ch olesteatom a of th e Middle Ear Milan : Gh edin i; 1980:91–96 Sann a M Con gen ital ch olesteatom a of th e m idd le ear In : Zin i C, Sh eehy JL, San n a M, eds Microsurger y of Ch olesteatom a of th e Middle Ear Milan : Gh edin i; 1980:149–156 Sann a M Ch olesteatom a in ch ildren (Exp erien ce of 2n d ENT clin ic of Parm a) In : Zin i C, Sh eehy JL, San n a M, eds Microsurgery of Ch olesteatom a of th e Middle Ear Milan : Gh edin i; 1980:157–160 Sann a M Proceedin gs of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali San n a M, Zin i C, Scan dellari R, Jem m i G Residual an d recurren t ch olesteatom a in closed t ym pan oplast y Am J Otol 1984; 5(4):277–282 Prasad SC, D’Orazio F, Medin a M, Bacciu A, San n a M State of th e art in tem poral 334 San n a M, Magn an i M, Gam oletti R Ossicular ch ain recon struct ion w ith plast ipore San n a M, Zin i C “Con gen ital ch olesteatom a” of th e m iddle ear A repor t of 11 cases Am J Otol 1984; 5(5):368–373 San n a M, Gam olet ti R, Magn an i M, Bacciu S, Zin i C Failures w ith Plasti-Pore ossicular replacem en t prosth eses Otolaryn gol Head Neck Surg 1984; 92(3):339–341 San n a M Man agem en t of labyrin th in e fistulae In : Marquet J, ed Surgery an d Path ology of th e Midd le Ear Boston , MA: Mart in us Niih o ; 1985 San n a M, Gam olet ti R, Scan d ellari R, Delogu P, Magn an i M, Zin i C Autologous fitted in cus versus Plastipore PORP in ossicular ch ain recon struction J Lar yn gol Otol 1985; 99(2):137–141 San n a M, Gam oletti R, Bortesi G, Jem m i G, Zin i C Posterior can al w all atrophy after in tact can al w all t ym pan oplast y Am J Otol 1986; 7(1):74–75 San n a M, Zin i C, Gam olet t i R, et al Preven tion of recurren t ch olesteatom a in closed t ym pan oplast y An n Otol Rh in ol Lar yn gol 1987a; 96(3, Pt 1):273–275 San n a M, Zin i C, Gam oletti R, et al Th e surgical m an agem en t of ch ildh ood ch olesteatom a J Lar yn gol Otol 1987b; 101(12):1221–1226 San n a M, Zin i C, Gam olett i R, et al Surgical treatm en t of ch olesteatom a in ch ildren Adv Otorh in olar yn gol 1987c; 37:110–116 San n a M, Zin i C, Bacciu S, et al Surger y for ch olesteatom a in ch ildren Proceedin gs of th e Th ird In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Copen h agen , Den m ark; Jun e 5–9, 1988 Am sterdam : Kugler & Gh edin i Publication s San n a M, Zin i C, Gam oletti R, Taibah AK, Russo A, Scan d ellari R Closed versus open tech n ique in th e m an agem en t of labyrin th in e fist ulae Am J Otol 1988; 9(6):470– 475 San n a M, Zin i C, Gam oletti R, Pasan isi E Prim ar y in t ratem poral tum ours of th e facial n er ve: diagn osis an d treatm en t J Lar yn gol Otol 1990; 104(10):765–771 San n a M, Sh ea CM, Gam oletti R, Russo A Surgery of th e ‘on ly h earin g ear’ w ith ch ron ic ear disease J Lar yn gol Otol 1992; 106(9):793–798 San n a M, Zin i C, Bacciu S, et al Man agem en t of labyrin th in e fistula Proceedin gs of th e Fourth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surgery; Niigata, Japan ; Septem ber 8–12, 1993 Am sterdam : Kugler Publication s San n a M, Zin i C, Gam oletti R, et al Pet rous bon e ch olesteatom a Skull Base Surg 1993; 3(4):201–213 San n a M, Mazzon i A, Saleh EA, Taibah AK, Russo A Lateral app roach es to th e m edian skull base th rough th e petrous bon e: th e system of th e m odified tran scoch lear approach J Lar yn gol Otol 1994; 108(12):1036–1044 San n a M, Mazzon i A, Taibah A, Saleh E, Russo A, Kh ash aba A Th e m odified tran scoch lear approach es to th e skull base: results an d in dication s In : Mazzon i A, San n a M, eds Skull Base Surger y Update Vol Am sterdam : Kugler; 1995a:315–323 San n a M, Saleh E, Russo A, et al Atlas of Tem poral Bon e an d Lateral Skull Base Surgery Stuttgart: Th iem e; 1995b San n a M Atlas of Acoustic Neurin om a Microsurger y Stut tgart: Th iem e; 1998 San n a M, Russo A, De Don ato G, et al Color Atlas of Otoscopy Stuttgart: Th iem e; 1999 San n a M, Agarw al M, Kh rais T, Di Trapan i G Modified Bon dy’s tech n ique for epit ym pan ic ch olesteatom a Laryn goscope 2003; 113(12):2218–2221 San n a M, Piazza P, Ditrapan i G, Agarw al M Man agem en t of th e in tern al carotid artery in t um ors of th e lateral skull base: preoperat ive perm an en t balloon occlusion w ith out recon struction Otol Neurotol 2004; 25(6):998–1005 San n a M, Russo A, Kh rais T, Jain Y, Augurio AM Can alplast y for severe extern al auditory m eatus exostoses J Lar yn gol Otol 2004; 118(8):607–611 San n a M, De Don ato G, Piazza P, Falcion i M Revision glom us tum or surger y Otolaryn gol Clin North Am 2006; 39(4):763–782, vii San n a M, Kh rais T, Man cin i F, Russo A, Taibah A Th e Facial Nerve in Tem poral Bon e an d Lateral Skull Base Surgery Stut tgart: Th iem e; 2006 San n a M, Bacciu A, Falcion i M, Taibah AK Surgical m an agem en t of jugular foram en sch w an n om as w ith h earin g an d facial n er ve fun ction preservation : a series of 23 cases an d review of th e literat ure Lar yn goscope 2006; 116(12):2191–2204 San n a M, Saleh E, Kh rais T et al Atlas of Microsurgery of th e Lateral Skull Base 2n d ed Stuttgart: Th iem e; 2007 References San n a M, Bacciu A, Falcion i M, Taibah A, Piazza P Surgical m an agem en t of jugular Sh eehy JL, Brackm an n DE, Grah am MD Ch olesteatom a su rgery: residual an d recur- foram en m en in giom as: a series of 13 cases an d review of th e literature Lar yn go- ren t disease A review of 1,024 cases An n Otol Rh in ol Lar yn gol 1977; 86(4, Pt scope 2007; 117(10):1710–1719 1):451–462 San n a M, Bacciu A, Pasan isi E, Taibah A, Piazza P Posterior petrous face m en in gio- Sh in SH, Sivalin gam S, De Don ato G, Falcion i M, Piazza P, San n a M Vertebral artery m as: an algorith m for surgical m an agem en t Otol Neurotol 2007; 28(7):942–950 involvem en t by t ym pan ojugular paragangliom as: m an agem en t an d outcom es San n a M, Bacciu A, Pasan isi E, Piazza P, Fois P, Falcion i M Ch on drosarcom as of th e w ith a proposed addit ion to th e fisch classification Audiol Neurootol 2012; 17 jugular foram en Lar yn goscope 2008; 118(10):1719–1728 (2):92–104 San n a M, Dispen za F, Flan agan S, De Stefan o A, Falcion i M Man agem en t of ch ron ic Sh in SH, Piazza P, De Don ato G, et al Man agem en t of vagal paragan gliom as in clud- otit is by m iddle ear obliterat ion w ith blin d sac closure of th e extern al auditory in g application of in tern al carotid artery sten tin g Audiol Neurootol 2012; 17 can al Otol Neurotol 2008; 29(1):19–22 (1):39–53 San n a M, Fois P, Russo A, Falcion i M Man agem en t of m en in goen ceph alic h ern iation Sivalin gam S, Kon ish i M, Sh in SH, Lope Ah m ed RA, Piazza P, San n a M Surgical m a- of th e tem poral bon e: Person al exp erien ce an d literature review Lar yn goscope n agem en t of t ym pan ojugular paragan gliom as w ith in tradural extension , w ith a 2009; 119(8):1579–1585 proposed revision of th e Fisch classification Audiol Neurootol 2012; 17(4):243– San n a M, Dispen za F, Math ur N, De Stefan o A, De Don ato G Oton eurological m an agem en t of petrous apex ch olesterol gran ulom a Am J Otolar yn gol 2009; 30 (6):407–414 San n a M, Fach arzt AA, Russo A, Lauda L, Pasan isi E, Bacciu A Modified Bon dy’s tech n ique: refin em en ts of th e surgical tech n ique an d lon g-term results Otol Neurotol 2009; 30(1):64–69 255 Sm yth GDL A prelim in ar y report of a tech n ique in t ym pan oplast y design ed to elim in ate th e cavit y problem J Lar yn gol Otol 1962; 76:460–463 Sm yth G Com bin ed app roach t ym pan oplast y Arch Otolar yn gol 1969; 89(2):250– 251 Sm yth GD, Dow e AC Cartilage can alplast y Lar yn goscope 1971; 81(5):786–792 San n a M, Piazza P, De Don ato G, Men ozzi R, Falcion i M Com bin ed en dovascular-sur- Taibah A, Russo A, Lan dolfi M, Sh aan M, San n a M Open tech n ique in ch olesteatom a gical m an agem en t of th e in tern al carotid artery in com plex t ym pan ojugular par- Proceedin gs of th e Fourth In tern ation al Con feren ce on Ch olesteatom a an d Mas- agangliom as Skull Base 2009; 19(1):26–42 toid Surger y; Niigata, Japan ; Septem ber 8–12, 1993 Am sterdam : Kugler San n a M, De Don ato G, Di Lella F, Falcion i M, Aggraw al N, Rom an o G Nonvascular lesion s of th e jugular foram en : th e gruppo otologico experien ce Skull Base 2009; 19(1):57–74 San n a M, Fois P, Pasan isi E, Russo A, Bacciu A Middle ear an d m astoid glom us tum ors (glom us t ym pan icum ): an algorith m for th e surgical m an agem en t Auris Nasus Lar yn x 2010; 37(6):661–668 San n a M, Pan dya Y, Man cin i F, Sequin o G, Piccirillo E Petrous bon e ch olesteatom a: classification , m an agem en t an d review of th e literat ure Audiol Neurootol 2011; 16(2):124–136 San n a M, Sh in SH, De Don ato G, et al Man agem en t of com plex t ym pan ojugular paragangliom as in cluding en dovascular in terven t ion Laryn goscope 2011; 121 (7):1372–1382 San n a M, Sun ose H, Man cin i F, Russo A, Taibah A Middle Ear an d Mastoid Microsurger y 2n d ed Stuttgart: Th iem e; 2012 San n a M, Piazza P, Sh in S, Flan agan S, Man cin i F Microsurger y of Skull Base Paragan gliom as Stut tgart: Th iem e; 2013 San n a M, Sh in SH, Piazza P, et al In fratem poral fossa approach t ype a w ith tran scon dylar-t ran stubercular extension for Fisch t ype C2 to C4 t ym pan ojugular paragan gliom as Head Neck 2014; 36(11):1581–1588 Saun ders WH, Paparella MM Atlas of Ear Surger y St Lou is, MO: Mosby; 1971 Sbaih at A, Bacciu A, Pasan isi E, San n a M Skull base ch on drosarcom as: surgical t reatm en t an d results An n Otol Rh in ol Lar yn gol 2013; 122(12):763–770 Sch ukn ech t HF Path ology of th e Ear 2n d ed Malvern : Lea & Febiger; 1993 Sch ukn ech t HF, Gylya JA An atom y of th e Tem poral Bon e w ith Surgical Im plicat ion s Ph iladelph ia, PA: Lea an d Febiger; 1986 Sh am baugh GE, Glasscock ME III Surger y of th e Ear 3rd ed Ph iladelph ia, PA: Saun ders; 1980 Sh aan M, Lan dolfi M, Taibah A, Russo A, Szym an ski M, San n a M Modified Bon dy tech n ique Am J Otol 1995; 16(5):695–697 Sh ea JJ, Hom sy CA Th e use of Proplast TM in otologic su rgery Lar yn goscope 1974; 84(10):1835–1845 Sh ea MC, Jr, Gardn er G, Jr Mastoid obliteration usin g h om ograft bon e Prelim in ar y repor t Arch Otolar yn gol 1970; 92(4):358–365 Sh eehy JL Surger y of ch ron ic otit is m ed ia In : Coates BM, Sch en k HD, Miller MV, eds Otolaryn gology Hagerstow n : Prior; 1965 Sh eehy JL Th e in tact can al w all tech n ique in m an agem en t of aural ch olesteatom a J Lar yn gol Otol 1970a; 84(1):1–31 Sh eehy JL Tym pan oplast y w ith m astoidectom y–a re-evaluation Lar yn goscope 1970b; 80(8):1212–1230 Sh eehy JL Surger y of ch ron ic otit is m edia: In : En glish GM, ed Otolar yn gology Vol Hagerstow n : Harper an d Row ; 1972: l–86 Sh eehy JL Ch olesteatom a surgery: can al w all dow n procedures An n Otol Rh in ol Lar yn gol 1988; 97(1):30–35 Sh eehy JL Surger y for ch ron ic otit is m edia In : En glish GM, ed Otolar yn gology 2n d ed Vol I Ph iladelph ia, PA: Lippin cott; 1990: l–86 Sh eehy JL, Pat terson ME In tact can al w all t ym pan oplast y w ith m astoidectom y A review of eigh t years’ experien ce Lar yn goscope 1967; 77(8):1502–1542 Publication s Taibah A, Russo A, Caylan R, Lan dolfi M, Man cin i F, San n a M Can al w all dow n procedures: Causes of failure an d pitfalls Proceedings of th e Fifth In tern ation al Con feren ce on Ch olesteatom a an d Mastoid Surger y; Algh ero-Sardin ia, Italy; Septem ber 1–6, 1996 Rom e: CIC Edizion i In tern azion ali Takah ash i S, Nakan o Y Tym pan oplast y w ith m astoid obliteration usin g hydroxyapatite gran ules In : Yan agih ara N, Suzucki Y, eds Tran splan ts an d Im plan ts in Otology Am sterdam : Kugler; 1992;159–163 Tos M Obliterat ion of th e cavit y in m astoidectom y Acta Otolar yn gol 1969; 67 (5):516–520 Tos M Pathogen esis an d path ology of ch ron ic secretor y otitis m edia An n Otol Rh in ol Lar yn gol Suppl 1980; 89(3, Pt 2):91–97 Tos M Modification of com bin ed-approach t ym pan oplast y in attic ch olesteatom a Arch Otolar yn gol 1982; 108(12):772–778 Tos M Man ual of Middle Ear Surger y Vol 1: Approach es Myrin goplast y Ossiculoplast y Tym pan oplast y Stuttgart: Th iem e; 1993 Tos M Man ual of Mid dle Ear Surger y Vol 2: Mastoid Surger y an d Recon structive Procedures Stut tgart: Th iem e; 1995 Tos M Man ual of Midd le Ear Surgery Vol 3: Surger y of th e Extern al Auditory Can al Stuttgart: Th iem e; 1997 Tos M, Lau T Att ic ch olesteatom a Recurren ce rate related to observation tim e Am J Otol 1988; 9(6):456–464 Tos M, Stan gerup SE Th e causes of asym m etr y of th e m astoid air cell system Acta Otolar yn gol 1985; 99(5–6):564–570 Tos M, Stan gerup SE, An dreassen UK Size of th e m astoid air cells an d otitis m edia An n Otol Rh in ol Lar yn gol 1985; 94(4, Pt 1):386–392 W igan d ME, Trillsch K Surgical an atom y of th e sin us epit ym pan i An n Otol Rh in ol Lar yn gol 1973; 82(3):378–383 Wullstein H Th e restoration of th e fun ction of th e m iddle ear, in ch ron ic otit is m edia An n Otol Rh in ol Lar yn gol 1956; 65(4):1021–1041 Wullstein HL, Wullstein SR Tym pan oplast y: Osteoplastic Epit ym pan otom y Stut tgart: Th iem e; 1990 Wullstein SR Osteoplastic epit ym pan otom y An n Otol Rh in ol Lar yn gol 1974; 83 (5):663–669 Yan agih ara N, Gyo K, Sasaki Y, Hin oh ira Y Preven t ion of recurren ce of ch olesteatom a in in tact can al w all t ym pan oplast y Am J Otol 1993; 14(6):590–594 Zin i C Hom otran splan tation de den t en t ym pan oplastie Rev Lar yn gol 1970; 91:258–261 Zin i C, San n a M, Jem m i G, Gan dolfi A Tran sm astoid extralabyrin th in e approach in traum atic facial palsy Am J Otol 1985; 6(3):216–221 Zin i C, San n a M, Bacciu S, Delogu P, Gam oletti R, Scan dellari R Molded t ym pan ic h eterograft An eigh t-year experien ce Am J Otol 1985; 6(3):253–256 Zin i C, Sh eehy JL, San n a M Microsurgery of Ch olesteatom a of th e Midd le Ear Milan : Gh edin i; 1993 Zölln er C, Bü sin g CM How useful is t ricalcium ph osph ate ceram ic in m iddle ear surger y? Am J Otol 1986; 7(4):289–293 Zölln er F Tym pan oplast y In : Coates G, Sch en ck HP, Miller MV, eds Otolar yn gology Vol Hagerstow n : Prior; 1959 335 Index Note: Page n um bers set bold or ita lic in dicate h eadin gs or figures, respectively – as surgical com plication 297, 301 ––– tran sotic approach in 184, 185– – com plication s w ith 136, 136, 137– 138 – congen ital 118, 162–166 186 – retraction pocket vs 118 – surgical t reatm en t of 139, 141–145, Eczem a, of extern al auditor y can al 25, 25 En doscope 3, 3–4 A –– classification of 160, 160–161 –– defin ed 160 – t ym pan oplast y in Exostosis 16–20 Aberran t carotid arter y 260, 260 –– h earin g loss in 160, 162–163 –– closed – defin ed 14 ABI, see Auditor y brain stem im plan t –– petrous bon e ch olesteatom a ––– w all dow n 145, 147–152 – osteom a vs 14 ––– w all up 118, 139, 141–145 – surger y for 21, 21, 22–24 (ABI) an d 160 147–152, 154–156, 157, 157 E Adh esive otitis m edia 82, 82, 83–92 –– progression of 160 –– epit ym pan ic 124, 127, 136 Extern al aud itory can al Am pulla, in pet rous bon e ch olesteato- – cystic retrot ym pan ic 128 –– m esotym pan ic 130–131 – carcin oid tum ors in 40, 40, 41 – defin ed 118 – w ith atelectasis 134, 134, 135 – carcin om a of 50, 51–52, 52–63 – dr y 126 Ch olesterol gran ulom a 76, 76, 77–80 – ch olesteatom a of 37, 38–40 – h earin g loss in 132 Ch on drosarcom a of jugular fora- – clean in g of 2, m a 183 An eur ysm , in tern al carotid artery 261, 261, 262 An giography, of t ym pan ojugular paragan gliom a 198, 202 – in ch ron ic supp urative otit is m edia 120, 121–129 m en 249, 249, 250 Ch orda t ym pan i – eczem a of 25, 25 – exostosis an d osteom as in 14, 14, 16–24 An n ulus 8–9 – in m yrin goplast y 301 Ch ron ic otitis m edia An terior t ym pan ic arter y – in tem poral bon e fracture 49 – m astoidectom y in 122 – facial n er ve t um ors in 44, 45 Atelectasis 82, 82–84, 86–90, 92 – in t ym pan oplast y 302, 310–312 – m yrin goplast y in 88, 112, 112, 113– – fibrous dysplasia in 49 – ch olesteatom a w ith 134, 134, 135 – m esotym pan ic 129, 129, 130–133 Auditor y brain stem im plan t (ABI) 329 – m odified Bon dy’s tech n ique for 124, Aural speculi 153, 154–156, 157, 157 115 – t ym pan ic m em bran e perforation 95– 96, 104–105 – forun colosis in 27, 104 – h ist iocytosis X in 41, 41 – in flam m ator y diseases of 25, 25, 26– 37 – of extern al auditor y can al 37, 38–40 –– an terior 97, 97, 98–99 B – petrous bon e 118 –– ch aracterist ics of 94 –– am pulla in 183 –– h ealin g of 94, 97–98 BAHI, see Bon e-an ch ored h earin g im - –– apical 169 –– h earin g loss in 94, 104 – m en in giom as in 42, 42, 43–44 plan t (BAHI) –– brain stem com pression in 181 –– in gran ulom atous otit is m edia 106 – m yrin gitis in 29, 29, 30–33 Billeau ear loop –– cerebrospin al fluid leak in 194 –– in otorrh ea 104–105 – n eurofibrom a in 48 Bon dy’s tech n ique 124, 153, 154–156, –– classification of 168–170 –– in t ym pan osclerosis 105–107, 107, – n eurom a in 47 157, 157, 321, 321, 322–323 Bon e-an ch ored h earin g im plan t (BAHI) 329 Brow n’s sign 197 C Can al w all dow n t ym pan oplast y 145, 147–152 Can al w all up t ym pan oplast y 139, 141–145 – See a lso Tym pan oplast y –– clivus 170, 180–181, 188 –– coch lear involvem en t in 173, 175– 176, 186, 188, 190, 193 108–109 – low er cran ial n er ve sch w an n om a in 46, 46, 47 – otit is extern a in 25, 26–27 –– in ferior 99, 99, 100 – otom ycosis in 27, 27, 28 –– posterior 94, 95–97 – path ologies exten din g to 40, 40, 41– 49 –– defin ed 168 –– post raum atic 102, 102, 103–104 –– facial n er ve in 174, 176, 184, 187, –– subtotal 101–102 – pleom orph ic aden om a in 48 –– total 101–102, 104 – post in flam m ator y sten osis surger y 189, 192, 193, 193 in 33, 34–37 –– h earin g loss in 174 – t ym pan osclerosis in 105–106, 107 –– h earin g preservation w ith 193 –– h earin g loss in 111 – sten osis gradin g 14 –– in cerebellopon tin e an gle 182 –– path ogenesis of 107 – tem poral bon e fracture in 49, 50 –– in congen ital ch olesteatom a 160 –– t ym pan ic m em bran e perforat ion –– in in tern al auditor y can al 174, 180, 186 in 105–107, 107, 108–109 –– w ith in tact t ym pan ic m em - F Facial n er ve Can alplast y –– in otoscopy 168 – for exostosis an d osteom a 17, 20–21, –– in fralabyrin th in e 169, 174–175 – w ith skin in m iddle ear 104–105 – in an atom y –– in fralabyrin th in e–apical 169 Ch ron ic suppurative otit is m edia, see – in can alplast y 21 21, 22–24 – for m yrin gitis 29, 31 – for tem poral bon e paraganglio- –– in tern al carotid artery in 188–189, 194 bran e 110, 110, 111–112 Ch olesteatom a – ch olesteatom a in 120, 121–129 – in petrous bon e ch olesteatom a 174, 176, 184, 187, 189, 192, 193, 193 –– in t radural 170, 185 –– m esotym pan ic 129, 129, 130–133 – in t ym pan oplast y 140, 146 – in m od ified Bon dy’s tech n ique 153 –– jugular bulb in 194 – retraction pocket in 119–120 – t um ors 44, 45, 250, 250, 251–260, – in t ym pan oplast y 147 –– labyrin th ectom y in 179 CI, see Coch lear im plan t (CI) Carcin oid tum ors 40, 40, 41 –– lateral sem icircular can al in 177, Clean in g, of extern al auditor y can al 2, m a 210 Carcin om a, of extern al aud itory can al 50, 51–52, 52–63 180 –– m assive 169, 179, 189 Carotid artery, aberran t 260, 260 –– m astoidectom y in 178 Carotid body t um ors 196 –– m edial extension of 172 Cerebellopon t in e an gle petrous bon e –– m odiolus in 187 ch olesteatom a 182 Clivus, petrous bon e ch olesteatom a in 170, 180–181, 188 Coch lea, in petrous bon e ch olesteato- 266 Fibrous dysplasia, in extern al aud itory can al 49 Fisch classification 198 Forun colosis 27, 104 Fracture, tem poral bon e 49, 50, 271 m a 173, 175–176, 186, 188, 190, 193 G –– n asoph ar yn x 170 Coch lear im plan t (CI) 329, 330 Cerebellopon t in e an gle tum ors 42 –– pon s involvem en t in 182 Coch leariform process Cerebrospin al fluid leak –– recurren t 178, 194 Con gen ital ch olesteatom a 118, 162– – in low er cran ial n er ve n eurin om a 72 –– residual 183 – in m en in goen ceph alic h ern ia- –– sigm oid sin us in 194 – classification of 160, 160–161 –– sph en oid sin us 170, 181–182 – defin ed 160 –– superior sem icircular can al in 177 – h earin g loss in 160, 162–163 –– supralabyrn th in e 169, 172–174, – petrous bon e ch olesteatom a an d 160 Han d-Sh ü ller- Ch ristian disease 41 – progression of 160 Hartm an auricular forceps t ion 268 – in petrous bon e ch olesteatom a 184, 194 – in tem poral bon e fracture 49 – in t ym pan ojugular paragangliom a 237, 240 Ch olesteatom a – acquired 118 176–177, 184, 191–192 –– surgical m an agem en t of 184, 185– 193 ––– m odified tran scoch lear approach in 184, 185 166 Gran u lom atous otitis m edia, t ym pan ic m em bran e perforation in 106 H Hearin g im plan ts 329, 330 Hearin g loss – in congen ital ch olesteatom a 160, 162–163 337 Index – in m astoidectom y 127 – in ch olesteatom a 122, 135, 139, 147 – in m esotym pan ic ch olesteatom a 132 – in ch ron ic supp urative otit is m e- – in otit is m edia 66, 83–84 – in closed t ym pan oplast y 140 – in t ym pan ic m em bran e perfora- – in lateral tem poral bon e resect ion 51 – in t ym pan osclerosis 111 – in m en in goen ceph alic h ern iation 268 Otorrh ea, t ym pan ic m em bran e perfora- Nasop h ar yn x, petrous bon e ch olesteatom a in 170 Necrotizing extern al otitis 25, 26 – See a lso Ch olesterol gran ulom a – in petrous bon e ch olesteatom a 178 Neurin om a, low er cran ial n er ve 247, High jugular bulb 262, 262, 263–265 – in tran sotic approach to petrous bon e Histology, of t ym pan ic m em bran e 11 – in t ym pan om astoid paragan glio- I Im plan ts, h earin g 329, 330 – postsurgical dition s in 320, 320, Notch of Rivin us Pars flaccida perforation 94 – petrous bon e ch olesteatom a in 174, Pars flaccida retract ion 82 321 In flam m ator y diseases, of extern al – m en in giom as in 42 agangliom a (TBP) Pars flaccida 8, 8–10 Meatoplasty In tern al auditor y can al Paragan gliom a, see Tem poral bon e par- – See a lso Sch w an n om a In cus, in an atom y A 237, 237 n al 48 P – in t ym pan oplast y 147 Meatal sten osis 29, 29, 30–33 In fratem poral fossa approach , t ype Neurofibrom a, in extern al auditor y ca- Oval w in dow Parot idectom y 51–52, 54, 59, 61–62, 64 In cudostapedial join t 9–10, 149 auditor y can al 25, 25, 26–37 247, 248 tion in 104–105 Neurom a, in extern al auditor y can al 47 m a 219 O Pars ten sa – in m od ified Bon dy’s tech n ique 153 Ossiculoplast y PBC, see Petrous bon e ch olesteatom a – in t ym pan oplast y 152 – displaced in cus in 307 – postsurgical dition s in 327, 327, – in adh esive otitis m edia 92 Petrosectom y, in ch olesteatom a 137 – in atelectasis 83, 85 Petrous bon e ch olesteatom a (PBC) 118 – in ch olesteatom a 125 – am pulla in 183 – in ch ron ic supp urative otit is m e- – apical 169 328–329 Men in giom as 42, 42, 43–44, 242, 242, 243–247, 265 Men in goen ceph alic h ern iation Pars ten sa perforation 94, 136 dia 125 (PBC) – brain stem com pression in 181 – defin ed 268 – in m yrin goplast y 113, 125 – cerebrospin al fluid leak in 194 In tern al carotid artery – etiology of 268 – in t ym pan ic m em bran e perfora- – classification of 168–170 – in petrous bon e ch olesteatom a 188– – im aging of 268, 269–276 180, 186 189, 194 – in t ym pan ojugular paragangliom a 236 In tern al carotid arter y an eur ysm 261, 261, 262 – m iddle fossa approach in 268, 269– 270, 283 – h igh 262, 262, 263–265 – in petrous bon e ch olesteatom a 194 Jugular foram en ch on drosarcom a 249, 249, 250 Jugular foram en sch w an n om a 46, 46 – in t ym pan osclerosis 97, 111–112 – coch lear involvem en t in 173, 175– 176, 186, 188, 190, 193 – defin ed 168 – subtotal petrosectom y in 137, 268, Osteom a 18–19 – facial n er ve in 174, 176, 184, 187, 275, 279, 279, 280–282, 283 – tran sm astoid approach in 276, 276, Jugular bulb – in t ym pan oplast y 303 – clivus 170, 180–181, 188 – retraction after 306 277–282, 283 J t ion 97, 99 – post traum atic 271 – surgical m an agem en t of 276, 276, 277, 283 –– w ith m in icran iotom y 278, 278, 279, 283 Mesot ym pan ic ch olesteatom a 129, 129, 130–133 – exostosis vs 14 189, 192, 193, 193 – surger y for 21, 21, 22–24 – h earin g loss in 174 Otit is extern a 25, 26–27 – h earin g preser vation w ith 193 Otit is m edia – in cerebellopon t in e an gle 182 – acute 66, 74, 74 – in congen ital ch olesteatom a 160 – adh esive 82, 82, 83–92 – in in tern al auditor y can al 174, 180, – ch ron ic –– m yrin goplast y in 88, 112, 112, 113– 115 186 – in otoscopy 168 – in fralabyrin th in e 169, 174–175 Microscope –– t ym pan ic m em bran e perforat ion – in fralabyrin th in e–apical 169 Middle ear im plan ts 329 ––– an terior 97, 97, 98–99 – in tern al carotid artery in 188–189, K Middle fossa app roach 268, 269–270, ––– ch aracterist ics of 94 Keratosis obturan s 37 Modified Bon dy’s tech nique 124, 153, 283 154–156, 157, 157, 321, 321, 322–323 194 ––– h ealin g of 94, 97–98 – in t radural 170, 185 ––– h earin g loss in 94, 104 – jugular bulb in 194 ––– in gran ulom atous otit is m edia 106 – labyrin th ectom y in 179 L Modified Fisch classification 198 ––– in otorrh ea 104–105 – lateral sem icircular can al in 177, 180 Modified Pit tsburgh staging 51 ––– in t ym pan osclerosis 105–107, 107, – m assive 169, 179, 189 Labyrin th ectom y Modiolus, in petrous bon e ch olesteato- – in petrous bon e ch olesteatom a 179 108–109 – m astoidectom y in 178 ––– in ferior 99, 99, 100 – m edial extension of 172 Myrin gitis 29, 29, 30–33, 299 ––– posterior 94, 95–97 – m odiolus in 187 Myrin goplasty ––– post raum atic 102, 102, 103–104 – n asoph ar yn x 170 – an n ulus in 112–113, 114 ––– subtotal 101–102 – pon s involvem en t in 182 – ch olesteatom a after 301 ––– total 101–102, 104 – recurren t 178, 194 Lateralization 298–299 – com plication s in 297, 297, 298–301 –– t ym pan ic m em bran e perforat ion – residual 183 Let ter-Siw e disease 41 – failures in 297, 297, 298–301 Low er cran ial n erve n eurin om a 247, – in ch ron ic otitis m edia 88, 112, 112, – in tran sotic approach to petrous bon e ch olesteatom a 185 Lateral tem poral bon e resect ion (LTBR) 51 247, 248 Low er cran ial n erve sch w an n om a 46, 46, 47 LTBR, see Lateral tem poral bon e resection (LTBR) m a 187 M Malign an t otit is extern a 25, 26 in 95–96, 104–105 – sigm oid sin us in 194 –– t ym pan osclerosis an d 105–106, 107 – sph en oid sin us 170, 181–182 –– t ym pan osclerosis in – superior sem icircular can al in 177 – in exostoses 20, 31 ––– h earin g loss in 111 – supralabyrn th in e 169, 172–174, – in m yrin gitis 31 ––– path ogenesis of 107 – in otorrh ea 104 ––– t ym pan ic m em bran e perforat ion 113–115 – in t ym pan ic m em bran e perforation 95–100, 103, 104, 104 338 Otom ycosis 27, 27, 28 N – in m od ified Bon dy’s tech n ique 153 ch olesteatom a 185 73 – ven t ilation tube for 66 Hem osiderin 76 Hist iocytosis X 41, 41 –– secon dar y to n eoplasm 69, 69, 70– w ith 286 dia 122, 127, 135 – in petrous bon e ch olesteatom a 174 tion 94, 97–98, 104 Myrin gotom y, postsurgical dition s – in t ym pan osclerosis 96, 99–100, 112 – postsurgical dition s w ith 293, 294–297, 299, 301 in 105–107, 107, 108–109 ––– w ith in tact t ym pan ic m em bran e 110, 110, 111–112 176–177, 184, 191–192 – surgical m an agem en t of 184, 185– 193 –– m odified tran scoch lear approach in 184, 185 –– w ith skin in m iddle ear 104–105 –– tran sot ic approach in 184, 185–186 – gran ulom atous, t ym pan ic m em bran e Ph otography 3, Malleus, an atom y 8–10 – prin ciples of 112, 112, 113–115 Mastoidectom y – skin curettage in 106 – h earin g loss in 66, 83–84 – h earin g loss in 127 – sten osis after 300–301 – secretor y 66, 66, 67–73, 90 perforation in 106 Pleom orph ic aden om a, in extern al auditor y can al 48 Index Pon s, in petrous bon e ch olesteatom a 182 Post in flam m ator y sten osis surger y 33, 34–37 Postoperat ive ch olesteatom a 37 – in petrous bon e ch olesteatom a 184 Subtotal tem poral bon e resect ion (STBR) 51, 61–62 Superficial parot idectom y 51, 54, 64 Supratubaric recess 10 – See a lso Ch olesteatom a Postoperat ive m yrin gitis 299 Postsurgical dition s – in h earin g im plan ts 329, 330 – in m astoidectom y 320, 320, 321 – in m eatoplast y 327, 327, 328–329 – in m od ified Bon dy’s tech n ique 321, 321, 322–323 – in m yrin goplast y 293, 294–297 – jugular foram en ch on drosarcom a 249, 249, 250 – low er cran ial n er ve n eurin om a 247, 247, 248 – m en in giom as 42, 42, 43–44, 242, 242, 243–247, 265 Tym pan ojugular paragan gliom as (TJPs) 196 – See a lso Tem poral bon e paragangliom a (TBP) – classification of 198, 199–204 – clin ical presen tation of 197 T – n eurofibrom a 48 – im aging of 197, 221, 221, 222–236 – n eurom a 47 – in an giography 198, 202 TBP, see Tem poral bon e paragangliom a – otit is m edia secon dary to 69, 69, 70– – in com puted tom ography 197, 201 (TBP) Tem poral bon e carcin om a 50, 51–52, 52–63 Tem poral bon e ch olesterol gran u lom a 76, 76, 77–80 73 – pleom orph ic aden om a 48 – in m agn etic reson an ce im aging 198, 203 – sch w an n om a – in tern al carotid ar tery in 236 –– as cerebellopon t in e an gle tum or 42 – low er cran ial n er ves in 236 –– as facial n er ve t um or 44 – surgical m an agem en t of 236 Tym pan om astoid paragangliom a, see – in m yrin gotom y 286, 299–300 Tem poral bon e fract ure 49, 50, 271 –– of low er cran ial n er ves 46, 46, 47 – in stapes surger y 290, 290, 291–293 Tem poral bon e paragan gliom a (TBP) – tem poral bon e paragangliom a – in t ym pan oplast y 301, 302–308, – carotid body 196 –– carotid body 196 – clin ical presen tation of 197 – classification of 198, 199–204 –– classification of 198, 199–204 – im aging of 213, 214–218 – clin ical presen tation of 197 –– clin ical presen tation of 197 – surgical m an agem en t of 218, 218, – defin ed 196 –– defin ed 196 – m yrin gitis as 299 – exam in ation fin din gs w ith 196 –– exam in ation fin din gs w ith 196 Tym pan oplast y Prom on tor y 8, 10 – gen etics of 196 –– gen etics of 196 – ch olesteatom a after 302, 310–312 Pyram idal em in en ce – im aging of 197 –– im aging of 197 – closed 118 – in fratem poral fossa approach to 237, –– in fratem poral fossa approach –– can al w all dow n 145, 147–152 315–319 – in ven t ilation t ube in ser tion 286, 286, 287–290 R Retraction pocket 82–84, 88–92, 118, 119–120 237 – surgical m an agem en t of 208, 208, 209–213, 218, 218, 219–221, 236 to 237, 237 –– surgical m an agem en t of 208, 208, 209–213, 218, 218, 219–221, 236 Tem poral bon e paragan gliom a (TBP) 219–221 –– can al w all up 139, 141–145 – facial n er ve in 140, 146 – failures an d com plication s in 308, – t ym pan ic 205, 205, 206–207 –– t ym pan ic 205, 205, 206–207 – ch olesteatom a vs 118 –– im aging of 205, 205, 206–207 ––– im aging of 205, 205, 206–207 – in ch olesteatom a Retrot ym pan ic m ass(es) –– surgical m an agem en t of 208, 208, ––– surgical m an agem en t of 208, 208, –– epit ym pan ic 124, 127, 136 – aberran t carotid artery as 260, 260 209–213 209–213 309–319, 324, 324, 325–327 –– m esotym pan ic 130–131 – dition s presen tin g as 242 – t ym pan ojugular 196 –– t ym pan ojugular 196 – m eatoplast y in 152 – facial n er ve t um ors as 44, 45, 250, –– classification of 198, 199–204 ––– classification of 198, 199–204 – m en in goen ceph alic h ern iation –– clin ical presen tation of 197 ––– clin ical presen tation of 197 –– im aging of 197, 221, 221, 222–236 ––– im aging of 197, 221, 221, 222–236 –– in an giography 198, 202 ––– in an giography 198, 202 153, 154–156, 157, 157, 321, 321, –– in com puted tom ography 197, 201 ––– in com puted tom ography 197, 201 322–323 –– in m agn etic reson an ce im aging 198, ––– in m agn etic reson an ce im ag- 250, 251–260, 266 – h igh jugular bulb as 262, 262, 263– 265 – in tern al carotid artery an eur ysm as 261, 261, 262 – jugular foram en ch on drosarcom as as 249, 249, 250 – low er cran ial n er ve n eurin om as as 247, 247, 248 – m en in giom a as 242, 242, 243–247, 265 Roun d w in dow 8, 10 203 in g 198, 203 after 269, 272, 274 – m odified Bon dy’s tech n ique 124, – open 118 – postsurgical dit ion s in 301, 302– –– in tern al carotid artery in 236 ––– in tern al carotid ar tery in 236 –– low er cran ial n er ves in 236 ––– low er cran ial n er ves in 236 –– surgical m an agem en t of 236 ––– surgical m an agem en t of 236 – t ym pan om astoid –– t ym pan om astoid Tym pan osclerosis –– clin ical presen tation of 197 ––– clin ical presen tation of 197 – h earin g loss in 111 –– im aging of 213, 214–218 ––– im aging of 213, 214–218 – path ogenesis of 107 –– surgical m an agem en t of 218, 218, ––– surgical m an agem en t of 218, 218, – retract ion pocket in 119 308, 315–319 – postsurgical dit ion s w ith 301, 302–308 219–221 219–221 – vagal 196 –– vagal 196 Sadè classification 82, 82 Ten sor t ym pan i Tym pan ic m em bran e – w ith in tact t ym pan ic m em - Sch w an n om a TJP, see Tym pan ojugular paragan glio- – an atomy 8, 8, 9–10 bran e 110, 110, 111–112 S – as cerebellopon t in e an gle tum or 42 m as (TJPs) Tym pan osclerotic plaque 98, 100 Type A in fratem poral fossa ap - Total parotidectom y 52, 61–62, 64 – physiology of 11 – of low er cran ial n er ves 46, 46, 47 Total tem poral bon e resect ion Tym pan ic m em bran e perforation Sigm oid sin us, in petrous bulb ch olesteatom a 194 Sph en oid sin us, petrous bon e ch olesteatom a in 170, 181–182 Stapedius ten don Stapes 10 Stapes surgery, postsurgical dit ion s w ith 290, 290, 291–293 (TTBR) 52 – ch aracteristics of 94 ceph alic h ern iation 276, 276, 277, – h ealin g of 94, 97–98 283 – h earin g loss in 94, 104 283 Traum a, t ym pan ic m em bran e perforation in 102, 102, 103–104 proach 237, 237 – an terior 97, 97, 98–99 Tran sm astoid app roach , in m en in goen - – w ith m in icran iotom y 278, 278, 279, in 105–107, 107, 108–109 – h istology of 11 – as facial n er ve tum or 44 Sh rapn ell's m em bran e – t ym pan ic m em bran e perforat ion U Um bo 9–10 – in gran ulom atous otitis m edia 106 – in otorrh ea 104–105 – in t ym pan osclerosis 105–107, 107, 108–109 V Vagal paragan gliom a 196 – in ferior 99, 99, 100 Ven t ilation t ube – posterior 94, 95–97 – for ch olesterol gran ulom a 76 Tum ors, see Ch olesteatom a – post raum atic 102, 102, 103–104 – for otit is m ed ia 66, 91, 92 Sten osis gradin g 14 – carcin oid 40, 40, 41 – subtotal 101–102 – in atelectasis 92 Subtotal petrosectom y – carcin om a, of extern al auditor y ca- – total 101–102, 104 – postsurgical dit ion s w ith 286, STBR, see Subtotal tem poral bon e resect ion (STBR) – in m en in giom a 42–43 – in m en in goen ceph alic h ern iat ion 137, 268, 275, 279, 279, 280– 282, 283 TTBR, see Total tem poral bon e resect ion (TTBR) n al 50, 51–52, 52–63 Tym pan ic paragan gliom a – ch olesterol gran ulom a 76, 76, 77–80 – im aging of 205, 205, 206–207 – facial n er ve 44, 45, 250, 250, 251– – surgical m an agem en t of 208, 208, 260, 266 286, 287–290 Video system 209–213 339 ... Color At las of Endo-Ot oscopy Exam inat ion–Diagnosis–Treat m ent Mar io San n a, MD Professor of Otolar yngology Depart m en t of Head an d Neck Surger y Un iversit y of Ch ieti... to th e low est part of th e h an dle of th e m alleus Most of Fig 2.1 Right ear Normal t ympanic mem brane 1, pars flaccida; 2, short process of the malleus; 3, handle of the malleus; 4, umbo;... short process of the handle of the m alleus, the umbo, the cone of light, the annulus, and the pars flaccida are seen Note also the presence of early exostosis in the superior wall of the external