scholarly journals Management of Jugular Bulb Injuries during Endoscopic Ear Surgery: Our Experience

2019 ◽  
Vol 80 (06) ◽  
pp. 608-611 ◽  
Author(s):  
Gaetano Ferri ◽  
Matteo Fermi ◽  
Matteo Alicandri-Ciufelli ◽  
Domenico Villari ◽  
Livio Presutti
Keyword(s):  
Preoperative Evaluation ◽  
Case Series ◽  
Vascular Complications ◽  
Chronic Otitis Media ◽  
Jugular Bulb ◽  
Massive Bleeding ◽  
Endoscopic Management ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Tertiary Referral Center

Objectives The main objective of this article is to describe endoscopic management of intraoperative massive bleeding from jugular bulb injury during exclusively transcanal endoscopic procedures for middle ear pathologies. Design Case series with chart review. Setting Tertiary referral center. Participants We retrospectively reviewed two patients who experienced jugular bulb injury during endoscopic transcanal approach for glomus tympanicum and chronic otitis media. The surgical videos and charts were carefully investigated and analyzed. Main Outcome Measures Feasibility and suitability of exclusive endoscopic management of jugular bulb bleeding and description of surgical maneuvers that should be performed to obtain safe and effective hemostasis. Results In both patients, jugular bulb bleeding was progressively controlled by means of exclusive endoscopic approach with no need to convert to microscopic approach. None of the cases required a second surgeon helping in keeping the endoscope during hemostatic maneuvers. Both patients had a normal postoperative period with no recurrence of hemorrhage. Conclusions Endoscopic management of jugular bulb bleeding is feasible by using the technique described with reasonable efficacy and with no additional risk or morbidity to the procedure. Knowledge of anatomy and its variants, preoperative evaluation of imaging, and the ability of the surgeon to adapt the surgical technique to the specific case are recommended to prevent vascular complications during endoscopic ear surgery.

Management of Bleeding in Exclusive Endoscopic Ear Surgery: Pilot Clinical Experience

2017 ◽  
Vol 157 (4) ◽  
pp. 700-706 ◽  
Author(s):  
Lukas Anschuetz ◽  
Marco Bonali ◽  
Pierre Guarino ◽  
Filippo B. Fabbri ◽  
Matteo Alicandri-Ciufelli ◽  
...  
Keyword(s):  
External Auditory Canal ◽  
Case Series ◽  
Surgical Instruments ◽  
Endoscopic Technique ◽  
University Hospital ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Tertiary Referral Center ◽  
Hemostatic Agents ◽  
Narrow Space

Objective Transcanal exclusive endoscopic ear surgery requires the management of the endoscope and the surgical instruments in the external auditory canal. Bleeding in this narrow space is one of the most challenging issues, especially for novice endoscopic ear surgeons. We aim to assess the severity and occurrence of bleeding and describe strategies to control the bleeding during endoscopic ear surgery. We hypothesize that bleeding is reasonably controllable in endoscopic ear surgery. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods We retrospectively assessed 104 consecutive cases of exclusive endoscopic ear surgery at the University Hospital of Modena, Italy. The surgical videos and the patient charts were carefully investigated and analyzed. Results Hemostatic agents included injection of diluted epinephrine (1:200,000, 2% mepivacaine), cottonoids soaked with epinephrine (1:1000), mono- or bipolar cautery, washing with hydrogen peroxide, and self-suctioning instruments. The localization of bleeding in the external auditory canal was most frequently the posterior superior part, and inside of the middle ear, it was the pathology itself. Statistical analysis revealed significant differences comparing the mean arterial pressure and the type of intervention among bleeding scores. Conclusion The management of bleeding in endoscopic ear surgery is feasible through widely available hemostatic agents in reasonable frequency. This study gives an instructive overview on how to manage the bleeding in the exclusive endoscopic technique. Even the highest bleeding scores could be managed in an exclusively endoscopic technique.

scholarly journals A Transcanal Endoscopic Approach for Management of Pulsatile Tinnitus due to High-Riding Dehiscent Jugular Bulb

2021 ◽  
pp. 014556132110436
Author(s):  
David Shang-Yu Hung ◽  
Wei-Ting Lee ◽  
Yi-Lu Li ◽  
Jiunn-Liang Wu
Keyword(s):  
Middle Ear ◽  
Coil Embolization ◽  
Jugular Bulb ◽  
Endoscopic Ear Surgery ◽  
Pulsatile Tinnitus ◽  
Clinical Consideration ◽  
Ear Surgery ◽  
High Jugular Bulb ◽  
Endovascular Coil Embolization ◽  
Transmastoid Approach

Pulsatile tinnitus (PT) caused by a high-riding dehiscence jugular bulb (HDJB) is a rare but treatable otology disease. There are several managements include transcatheter endovascular coil embolization, transvenous stent–assisted coil embolization, or resurfacing the dehiscent bony wall of high jugular bulb under the use of microscope. Among those options, surgical resurfacing of HDJB might be an effective and safe choice with less destruction. However, previous studies approached middle ear cavity via microscope can only provide a lateral, indirect view, while resurfacing the vessel through a transcanal endoscopic ear surgery (TEES) approach may give surgeon a direct and easy way to manage HDJB. In this report, we presented a case of 40-year-old woman with HDJB and shared our clinical consideration and reasoning of the surgical management of PT via a transtympanic approach by TEES rather than a transmastoid approach.

scholarly journals Surgical results of transcanal endoscopic ear surgery in chronic otitis media.

2016 ◽  
Vol 130 (S3) ◽  
pp. S216-S216
Author(s):  
Masafumi Ohki ◽  
Masatoshi Takashima ◽  
Yuka Kitano ◽  
Atsushi Tahara ◽  
Sunao Tanaka ◽  
...  
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Surgical Results ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery

Total Endoscopic Ear Surgery in management of cochleocele: A case series

2020 ◽  
Vol 135 ◽  
pp. 110109 ◽  
Author(s):  
F. Mok ◽  
C.G. Leonard ◽  
M.A. Adams ◽  
K. Trimble ◽  
B.C. Papsin ◽  
...  
Keyword(s):  
Case Series ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery

Comparative Study of Endoscopic and Microscopic Type I Tympanoplasty in Terms of Delayed Facial Palsy

2020 ◽  
pp. 019459982094563
Author(s):  
Kuan-Hui Li ◽  
Leong-Perng Chan ◽  
Chin-Kuo Chen ◽  
Shin-Huei Kuo ◽  
Ling-Feng Wang ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Facial Palsy ◽  
Chronic Otitis Media ◽  
Immunoglobulin M ◽  
Type I ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Varicella Zoster ◽  
Type I Tympanoplasty ◽  
Simplex Virus

Objective Delayed facial palsy is a complication of otologic surgery. Tympanoplasty is commonly employed in chronic otitis media. We compared the incidence and characteristics of delayed facial palsy and hearing restoration between endoscopic and microscopic tympanoplasty for the treatment of simple chronic otitis media. Study Design Retrospective cohort study. Setting Tertiary medical center. Subjects and Methods We retrospectively analyzed 468 patients who underwent type I tympanoplasty from January 2009 to April 2017. Patients were divided into transcanal endoscopic ear surgery and microscopic ear surgery groups. Their epidemiological profiles were reviewed and the outcomes of tympanoplasty were analyzed. Blood sample tests for herpes simplex virus and varicella-zoster virus immunoglobulin M and immunoglobulin G were arranged in patients with delayed facial palsy. Results Transcanal endoscopic ear surgery exhibited similar benefits to microscopic ear surgery in graft-taking rate and hearing restoration but had a shorter operation time ( P < .01). Eight patients (1.71%) developed delayed facial palsy, but no statistically significant difference was observed between the 2 surgical approaches. All patients tested negative for varicella-zoster virus and herpes simplex virus immunoglobulin M and positive for immunoglobulin G of the same viruses; however, the titer did not exhibit a 4-fold increase, implying that patients did not have active viral infections. Conclusion Transcanal endoscopic ear surgery is an ideal alternative for simple tympanoplasty. The incidence of delayed facial palsy was not significantly different between the 2 approaches. Because of the favorable prognosis and the absence of direct serological evidence supporting viral reactivation, treatment with antivirals may not be required.

scholarly journals Endoscopic ear surgery in the ear camp setting; forward thinking or folly?

2017 ◽  
Vol 132 (1) ◽  
pp. 68-70 ◽  
Author(s):  
M P A Clark
Keyword(s):  
Clinical Setting ◽  
Operative Technique ◽  
Care Setting ◽  
Chronic Otitis Media ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Image Capture ◽  
Local Staff ◽  
Self Sufficiency ◽  
Ear Camp

AbstractBackground:Endoscopic ear surgery is becoming an accepted technique in otological surgery, in the management of chronic otitis media.Methods:The technique was introduced to the humanitarian care setting of an ear camp in Nepal to consider the appropriateness of the technique in this type of clinical setting.Results:Fifteen cases of myringoplasty were successfully completed.Conclusion:The apparent advantages of the endoscopic approach over the traditional microscopic one were the ease of transporting the equipment and the optimal view obtained of the tympanic membrane. The ability for pathology and operative technique to be observed equally well by the surgeon and local staff was helpful for teaching, and enables a move towards self-sufficiency of care. Easy image capture also has potential for remote telemedicine applications.

Assessment of Pain and Analgesic Use in Children Following Otologic Surgery

2020 ◽  
pp. 019459982097118
Author(s):  
Liliya Benchetrit ◽  
Megan Kwock ◽  
Evette Ronner ◽  
Sheli Goldstein ◽  
Edina Shu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Tertiary Care ◽  
Case Series ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Otologic Surgery ◽  
Pain Ratings ◽  
The Mean ◽  
Analgesic Use

Objective To compare postoperative pain and analgesic use in children following transcanal endoscopic ear surgery (TEES) vs non–transcanal endoscopic ear surgery (non-TEES). Study Design Prospective case series. Setting Tertiary care center. Methods Surveys using the Wong-Baker FACES Pain Rating Scale and recording the frequency and dosage of consumed analgesics were administered prospectively to caregivers of children undergoing otologic surgery between May 2018 to February 2020. Pain intensity and medication use were recorded twice daily for 6 days, starting on postoperative day 0. Mean pain scores and mean number of consumed analgesic doses were compared between groups. Results Survey response rate was 57.9%. Among 53 patients who completed the survey, 35 (66.0%) underwent TEES and 18 (34.0%) underwent non-TEES. Mean pain ratings on postoperative days 0 and 1 were significantly lower among children undergoing TEES (2.2 and 2.1) vs non-TEES (4.0 and 4.1), P = .045 and P = .008, respectively (Mann-Whitney U test). The mean pain ratings across the 6 days were similar in TEES (1.7) and non-TEES (2.6) ( P = .140, Mann-Whitney U test). The mean number of analgesic doses consumed per half-day over the 6 days was significantly lower among children undergoing TEES (0.3) vs non-TEES (0.6; P = .049, Mann-Whitney U test). Conclusion Postoperative pain following TEES and non-TEES in children was overall low. Children undergoing TEES had a small but statistically significant decrease in pain on postoperative days 0 and 1 and decreased use of pain medications compared to non-TEES.

Sign in / Sign up

Export Citation Format

Share Document