By Mario, M.D. Sanna
Univ. of Chieti, Italy. Atlas of otologic and neurotologic prognosis and therapy. features a number of otoscopic perspectives of various lesions. top of the range, full-color pictures and illustrations. Emphasis is put on how the view and medical photograph may well impact the alternative of remedy and surgical procedure. For clinicians. DNLM: Ear Diseases--diagnosis atlases.
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Additional resources for Color Atlas of Otoscopy
When indicated, the resection can include a superficial parotidectomy, resection of the mandibular condyle, and/or neck dissection. When the tumor has a deeper extension towards the middle ear, en-bloc subtotal resection of the temporal bone is indicated. In such cases, a middle and posterior fossa craniotomy is necessary. Bone removal is performed up to the level of the medial third of the petrous apex and the internal carotid artery. The facial nerve and inner ear are sacrificed. A more extended procedure is total en-bloc resection of the temporal bone entailing, in addition, the sacrifice of the internal carotid artery, closure of the sigmoid sinus and jugular bulb, and in some cases a total parotidectomy and neck dissection.
Should erosion or fixation of the ossicles be found, ossiculoplasty is performed. Fixation of the stapes is an indication for stapedotomy. In cases associated with tympanic membrane perforation, it is often possible to perform a single-stage reconstruction in which myringoplasty is performed with or without ossiculoplasty. A fixed stapes, however, is an indication for staging where myringoplasty is performed first, followed by a second-stage stapedotomy after a few months. In all suspected cases, the patient should be informed preoperatively of the possibility of staging surgery.
Tympanosclerosis and intact drum. The majority of the tympanic membrane is thinned due to atrophy of the fibrous layer. Two tympanosclerotic plaques are present near the anterior and posterior margins. 38 Left ear. The intact tympanic membrane shows tympanosclerotic plaques lying both anterior and posterior to the malleus that alternate with areas of atrophy (in the inferior quadrants). 39 Left ear. Tympanosclerosis with intact drum. A large plaque is visible in the posterior quadrants of the tympanic membrane.