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Tailor-made Chronic Ear Surgery Treatments

Chronic Ear Surgery: Surgical Techniques and Avoidance of Complication

Wednesday, October 7, 8:00 – 9:00 am (ET)

 

When it comes to chronic ear surgery techniques, one size does not fit all.

Matthew L. Kircher, MD

“A well-prepared chronic ear surgeon will be able to use a wide variety of surgical techniques to specifically address each patient’s ear pathology,” said Matthew L. Kircher, MD, of Loyola University Medical Center.

Dr. Kircher and co-presenters Seilesh Babu, MD, of Michigan Ear Institute, and Eleanor Y. Chan, MD, FRCSC, of Michigan Ear Institute and Wayne State University, will discuss a breadth of surgical treatments that have their own individual advantages and disadvantages depending on the case. One such technique is the utilization of graft material.

“Grafting material in chronic ear surgery most commonly consists of temporalis fascia, auricular cartilage, and/or auricular perichondrium,” said Dr. Kircher. “These autografts are harvested either through the same or separate incisions for surgical approach.”

But again, the approach depends on the individual patient.

“Obviously, limiting additional incisions is ideal and some surgeons may use xenograft of synthetic grafting material,” he said. “However the majority of ear surgeons will routinely make a postauricular incision and harvest temporalis fascia as a standard chronic ear surgical step. This approach requires only one incision for surgical exposure and graft harvest. In transcanal procedures, the incision for obtaining tragal cartilage/perichondrium can be concealed on the inside of the external auditory canal, preserving the large cartilage rim to avoid cosmetic pinna deformity.

A transcanal procedure can be done with either a binocular surgical microscope or endoscopic technique. “Both techniques are minimally invasive, as incisions are typically limited to inside the external auditory canal,” said Dr. Kircher. “Advantages for the microscope include two working hands (suction and dissector) and a three-dimensional (binocular) depth of surgical visualization. Disadvantages include poor visualization into some middle ear air cell tracts (sinus tympani and/or hypotympanic air cell tracts). Advantages for the endoscope include improved visualization into middle ear air cell tracts with disadvantages including only one working hand at a time; the other hand is holding the endoscope. Chronic ear surgeons should be able to utilize the microscope and/or endoscope when addressing patient-specific pathology.”

“The bottom line,” said Dr. Kircher, “is that all established chronic ear surgical techniques have advantages and disadvantages, and the well-prepared ear surgeon can individually select the surgical approach and method best suited to match each patient’s needs.”

If you miss this live event, it will become available in the on-demand library of education content within 72 hours following the presentation.

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