Endoscopic Ear Surgery: A New Horizon Saurav Sarkar
INDEX
Page numbers followed by f refer to figure.
A
Acute otitis media 29f, 36f
Anesthesia 41, 54, 62, 68
Apertura tympanica canaliculi chordae 12
Arnold's nerve 11
Attic erosion with
cholesteatoma 31f, 34f
right ear 35f
exposed malleoincudal joint 28f
Attic perforation in left ear 65f
Attic retraction
anterior 28f
OME with stage I 31f
stage I 29f
stage II 31f
stage III 29f
Attico antrostomy 65, 65f
Atticotomy 64
Auditory canal, external 11, 12
B
Bony sulcus 68f
Brain stem implantation in cadaveric heads 4
C
Camera system and monitor 9
Canal of huguier 13
Canal skin pedicle grafts 53
Canal, posterior superior 32f
Carotid artery, internal 13
Cholesteatoma 59
attic perforation with 30f
classification of 61
Chorda tympani 56f
Chordae posterius 12
Cigarette paper 39
piece of 40f
Cochlear otosclerosis 67
Cochlear window 14
D
Deep auricular branch 12
Deep petrosal nerve 13
Dimeric tympanic membrane 36f
Drug preparation 47
Dry wax 30f
E
Ear
canal, external 11
endoscopic anatomy of 11
procedures 25
Endoscopic dissection 22f
Endomeatal incision 68
Endoscope 9, 71
advantages of 75
placement during surgical procedure, principles of 10
placement, principles of 10f
vs microscope 73
Endoscopic cartilage tympanoplasty 57f
Endoscopic disease classification 79
Endoscopic ear surgery 1, 3, 5, 9
Endoscopic intratympanic
aminoglycoside 47
steroid 45
dosage 45
Endoscopic myringotomy 41
Endoscopic stapes surgery 67
Endoscopic tympanoplasty 57
Epithelial layer 11
Epitympanic space, posterior 17
Eustachian tube microendoscope 4
F
Facial canal 13, 69f
Facial nerve canal 14
Fenestra cochleae 13
Fenestra ovalis 13
Fenestra rotunda 13
Fenestra vestibuli 13
Fiberoptic endoscopes 4
Fissura petrotympanica 12
Flaccida retraction of left ear 28f
Fossa incudis 13
Fungal hyphae in external auditory canal 36f
G
Gel foam 39
Glasserian fissure 12
H
Hartmann's aural dressing forceps 9
Hypotympanum 4
I
Incudomalleolar joint 64f
Incudostapedial joint being dislocated 70f
Injection methodology 47
L
Left ear, stage II attic retraction of 29f
Ligament of malleus 13
Local anesthesia, technique of 62
M
Malleoincudal joint 34f
Malleus 19
handle of 56f
Mastoid 61
air cells 12
pneumatization 61
surgery 9
endoscopic 59
Meatus acusticus externus cartilaginous 11
Membrana tympani 12
Meniere's disease 45
Middle ear 4, 12, 13, 31f, 61, 68f
effusion 28f
endoscopy in 13
fluid in 28f
glue 42f
physiology of 53
Mucosal COM
active 48, 49, 49f, 51
inactive 48, 48f, 49
Mucosal polyp 34f
Myringotomy 9
N
Notch of rivinus 12
O
Operation, steps of 41
Otitis media
acute 41
adhesive 29f
chronic 48
healed 49, 50f
serous 42f
with effusion 28f
Otoendoscopic surgery 79
Otologic surgery, tenets of 3
Otomycosis 32f
Otosclerosis 67
P
Paries labyrinthica 13
Paries mastoidea 13
Pars flaccida retraction, stage I 35f
Pediatric nasal endoscopes 9
Petrotympanic fissure 12
Pitfalls of operation 43
Pneumatization of mastoid, failure of 61
Ponticulus 15
Posterosuperior bony scutum 69f
Prominent malleal vessels 29f
Prominentia canalis facialis 13
Protympanum 4
Prussack's space 18, 59
R
Right ear 30f
stage I attic retraction of 29f
Road ahead 77
Rosen's incision 68
S
Sensorineural hearing loss 44
causes 44
investigations 44
Serous otitis media 41
Sinus tympani 14-16
deep 14
endoscopic anatomy of 14
inferiorly 13
Squamous COM
active 51f
inactive 50, 50f
Stapedius tendon 70f
Steroids, advantages to 44
Surgery, stapes of 9, 68
Surgical area, preparation of 55
Systemic steroids 44
T
Temporalis fascia 56f
Transtympanic middle ear endoscopy 4
Triangular knife 9
Trichloro acetic acid 38, 39f
Tympanic annulus elevated 68f
with tympanomeatal flap 56f
Tympanic cavity 12
Tympanic membrane 12, 27, 28f, 31f, 36f, 39f, 45f, 56f
anterior segment of 32f
perforation 27, 39
etiology of 54
on hearing 53
post-traumatic healing 30f
right 32f
treatment of 38
Tympanic plexus 13
Tympanic sinus, posterior 13
Tympanomeatal flap
elevated 65f
repositioned 57f, 71f
Tympanoplasty 53, 55
contraindications of 54
indications for 54
Tympanosclerotic plaque 32f
V
Ventilation tube 43
insertion 43
×
Chapter Notes

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1ENDOSCOPIC EAR SURGERY: A New Horizon
3ENDOSCOPIC EAR SURGERY: A New Horizon
Saurav Sarkar MBBS MS-ENT FACS Assistant Professor Department of ENT & HNS AIIMS, Bhubaneswar, Odisha, India Foreword Renuka Bradoo
4
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Endoscopic Ear Surgery: A New Horizon
First Edition: 2016
9789385891625
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5Foreword
It gives me great pleasure to write a foreword for Endoscopic Ear Surgery: A New Horizon by Dr Saurav Sarkar. I have had the pleasure of interacting with Dr Sarkar at various academic conferences and I was always struck by his enthusiasm for knowledge as well as for original thought. So it came as no surprise when he called to tell me that he had written a book on endoscopic ear surgery and he wished me to review it.
The book is meticulously crafted with a great attention to detail. The sequence of chapters flows seamlessly from one to the other—the previous chapter laying a foundation to the next until the concept as a whole is crystal clear. The chapter on Equipment and Set Up addresses basic but often overlooked issues, such as the position of the surgeon and the endoscope placement. The hallmark of a good teacher is one who is able to make very complicated concepts deceptively simple to understand. The chapter on Endoscopic Anatomy of the Ear explains complex nuances especially those of the middle ear spaces brilliantly. The diagrammatic representation of these spaces is beautifully and clearly illustrated.
The chapter on Diagnostic Otoendoscopy is a ‘must read’ for all postgraduate students as it comprehensively covers most of the middle ear pathologies so important for the ‘long case’ of the MS examination. The photographs themselves are very well taken. The different ear surgeries are explained in increasing order of difficulty—the steps of each procedure being described in detail. The book ends on a mature and balanced note, discussing both the advantages and the limitations of the endoscope vis-a-vis the microscope.
As I read the last section on the future of endoscopic ear surgery, I was filled with a sense of anticipation and excitement. I believe that FEES—functional endoscopic ear surgery—is probably the first step of what is going to be a long and exciting journey… just as FEES once was. There is a whole new world of otology waiting to be discovered and I congratulate Dr Saurav Sarkar on his pioneering effort in this field.
Renuka Bradoo
Professor and Head
LTMGH & LTMMC
Sion, Mumbai, Maharashtra, India
7Preface
With the blessings of God Almighty, I dedicate this book to the three most important women of my life. My mother, Mrs Dipali Sarkar, who brought me into this world and made me what I am; my sister, Mrs Sweet Sarkar, who made my growing up memorable, and my wife, Mrs Meghmala Sadhukhan Sarkar, for being my inspiration.
Endoscopic surgery fascinated me since my early days of residency. Surgeries by Prof (Dr) Renuka Bradoo left an indelible impression on my mind. I always tried to communicate with madam when in difficult situations and she always responded like a true teacher. She showered her blessings and expert advice without any hesitation whenever we met in conferences throughout the country and I looked forward to those meetings. Ever since, she became my inspiration to perform newer things and surgeries with the endoscope. Thus began my journey into the realm of endoscopic surgery.
Endoscopic ear surgery is the new toddler taking baby steps in the vast world of otosurgery. This book aims at guiding beginners to start practising endoscopic otosurgery. At the outset, it must be emphasized that it has not yet become a replacement for the age old microscopic ear surgery but is complementary to it. To start endoscopic ear surgery, the surgeon must be well-versed with microscopic ear surgery, practise cadavers and then, attempt to start endoscopic ear surgeries in clinicial practice because “surgeries are done because the patient needs to get operated and not because the surgeon wants to operate.”
I started endoscopic ear surgery and received tremendous encouragement from Prof (Dr) SP Bera in Calcutta Medical College. I would thank Prof (Dr) Biswajit Sikder for believing in me and allowing me to perform the ear surgeries endoscopically. I would like to specially mention my beloved junior colleague, Dr Swagatam Banerjee, who not only helped me in my surgeries and in writing this book but also was my worst critic who could bring the best out of me. His IT skills helped me document my work which helped me earn accolades in various competitions throughout the country and enabled me to provide the photographs for this book. I would like to thank my friend, Dr Abhishek Jaswal, for his encouragement during my early struggles and for being my first inspiration behind contributing to medical literature.
My sincere thanks to Prof (Dr) BK Raychaudhuri who guided me during my formative years in residency and helped me start my enthralling journey in this subject. I would like to thank Prof (Dr) Amitabha Roychoudhury for being my inspiration for endoscopic surgeries and his constant support and encouragement. I would like to thank Prof (Dr) AK Chatterjee for being my guide during my residency and Prof (Dr) Ranjan Raychowdhury for his words of wisdom. I would like to thank Prof (Dr) AM Saha for being a supportive teacher a student always needs. I would also like to thank Prof (Dr) AK Saha for his blessings during my UG and PG course, and Prof (Dr) S Mukherjee for his kind words of encouragement.
I extend my gratitude to my colleagues Dr Sanjoy Kr Ghosh, Dr Animesh Ghosh, Dr Aloke Sil, Dr Prasanta Ghosh, Dr Sharmistha Chakravarty Ghosh, Dr Rajiv Singh, Dr Shoham Banerjee, Dr Subhasis Saha, Dr Swapan Bera, Dr Shaswati Sengupta, Dr Kankan Aguan, Dr Sudip Maity, Dr Smita Roy, Dr Saikat Samaddar, Dr Abir Chaudhury, and Dr Richard Narjinary for their unwavering support. My heartfelt thanks to Dr Soumitra Ghosh, Dr Bidhan Chowdhury, Dr Sayan Banerjee, Dr Kaushik Mandal, Dr Kamalika Purakayastha, Dr Sona Pasari, and Dr Sudipta Das.
I would like to thank our anesthesiologists, Dr Tushar Chakravorty and Dr Shilpi Sen, for providing me the anesthetic support during my surgeries. I sincerely thank the nursing staff and the support staff in our OT who helped me in my surgeries directly or indirectly. I would like to thank all my students for bringing a fresh leash of life and enthusiasm every year.
Above all, I wish to express my heartfelt gratitude and sincere regards to all my patients for believing in me and for being my best teacher, teaching me things which books never could. I am grateful to God for giving me the opportunity to serve you during your ailments.
Saurav Sarkar
9Acknowledgments
My professional foundation was laid by two great teachers and mentors Prof (Dr) BK Raychaudhuri, and Prof (Dr) Amitabha Roychoudhury, who introduced me the world of Otorhinolaryngology. They inspired me with their amazing skills and encouragement. I am fortunate to get quality education from these two renowned teachers and great surgeons. Their encouragement helped me to do new things and come out with this book on Endoscopic Ear Surgery.
I take this opportunity to thank the Director of AIIMS, Bhubaneswar, Prof (Dr) AK Mohapatra for his constant encouragement and his words of wisdom. I would like to thank my colleagues Dr C Preetam, Dr Dillip Samal, and Dr Anjan Sahoo, for their constant support. I would like to thank my friend and confidante Dr Umesh Shukla and Dr Madhusudan for their support.
I would like to thank Prof (Dr) Ramanuj Sinha, Prof (Dr) TK Hazra, Prof (Dr) BB Pakira, Prof (Dr) D Burman, Dr Rathin Sarkar, and Dr Soumya Ghatak, for all their support and advices.
I would like to express my thanks to all my seniors, juniors and my beloved students of NRS Medical College, Calcutta Medical College and AIIMS, Bhubaneswar for showering their trust and love over me. I would like to express my deepest gratitude to all the patients I have attended for being my best teacher.