Download Endoscopic Ear Surgery: Principles, Indications, and Techniques 2014 PDF 

Download Endoscopic Ear Surgery: Principles, Indications, and Techniques 2014 PDF 
by Daniele Marchioni  (Author), Livio Presutti  (Author)

Increasingly used as an adjunctive tool in the diagnosis and management of ear disease, middle ear endoscopy has the potential to decrease patient morbidity, prevent disease recurrence, and reduce costs. Its capacity to uncover “hidden” anatomy within the small dimensions of the ear has made it essential for functional surgery, allowing surgeons to preserve key anatomic structures such as the cochlea and facial nerve.

Now for the first time, the physicians who pioneered this groundbreaking minimally invasive technique review its indications, advantages, disadvantages, and surgical approaches:

Written by the foremost leaders in the field, all members of the International Working Group on Endoscopic Ear SurgeryFeatures nearly 1,000 intraoperative endoscopic images filmed with high-definition cameras, plus outstanding line drawings that aid in understanding all concepts

Comprehensively covers the field, including chapters on endoscopic and combined endoscopic-microscopic management of cholesteatoma, surgical restoration of middle ear ventilation, myringoplasty, Meniere disease, tympanoplasty and stapes surgery, revision surgery, and much more
Demonstrates state-of-the-art endoscopic procedures in 19 instructive videosFrom the unique anatomy and 
pathophysiology of the middle ear through diagnosis, surgical indications, procedures, and instrumentation, this book is indispensable for all otolaryngologists and neurotologists. It offers a full picture of the field today, as well as exploring the future possibilities of ear endoscopes alone or in combination with operative microscopes for the most effective treatment of middle ear pathologies.

The idea to develop and systematize endoscopic surgery of the ear,on the basis of the previous experience of great masters such asJean Marc Thomassin and Muaaz Tarabichi, arose from the consideration that the ear remained one of the few organs of the bodyon which no progress had been made in surgical procedure in the
previous 30 years, especially in the direction of minimally invasiveapproaches. Furthermore, despite the small dimensions of the ear,technological development—with particular reference to highdefinition cameras and the quality of the optics—has made possiblethe application of endoscopic techniques much more easily than inthe past.
The introduction of the endoscope through the ear has enabledthe exploration of hidden areas and the rediscovery of a complexanatomy consisting of ligaments, folds, and bone not otherwisevisible by microscopic techniques.
This rediscovery has also encouraged us to review some concepts of the anatomy, and some pathophysiological concepts.We have focused our attention on the study of the pathways ofventilation of the middle ear. Thanks to the new endoscopictechniques it was easy to study the aeration pathways of affected
ears in comparison with the nonaffected ear.
Endoscopic surgery of the ear was thus not simply a techniquefor performing surgery through the external auditory canal:according to our philosophy, it represented the introduction ofthe concept of “functional surgery.”This tries not only to treat and remove the pathology but also to maintain or restore the anatomy and physiology of the ear as close as possible to the normal condition. The key to these concepts lies in the principle of conservation of the entire mucosa, avoiding mastoid removal when possible and restoring ventilation and connection between the mesotympanic spaces and attic/mastoid compartments.
A further challenge is the use of the endoscope during the surgery of lesions involving the petrous apex or the fundus of theinternal auditory canal. In these cases, the endoscopic approach allows us to preserve crucial anatomical structures such as the cochlea and the facial nerve.
In particular, use of the endoscope after the microscopic phase of surgery of the inner ear allows removal of lesions from this anatomical area while avoiding the rerouting of the facial nerve that is otherwise required by the use of only the microscope. This results from the ability of the endoscope to “see around the corner,” so that one can work around the nerve without displacing it.
In applying this technology, we hold strongly to the conventional view that the tool must never determine the surgicalat titude but rather the contrary: the anatomical and physiological characteristics of the pathology must suggest to the surgeon what kind of tools to use for the best outcome and benefitof the patient.
Our task in completing this work was very onerous, requiring several dissections and the clinical experience of several years. We will be gratified if the otological international community appreciates our effort and commitment in bringing thefield to this point. Nevertheless, we are well aware that this is only a starting point and certainly not a point of arrival

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