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Acquired aural cholesteatoma poses a unique procedural dilemma with regard to pathogenetic research and theory building. Because cholesteatoma spontane ously occurs only in the poorly pneumatized human ear, its pathogenesis is specific to humans. Nonetheless, because of the ethical questions surrounding human experimentation, pathogenetic study has almost exclusively involved nonhuman subjects. Indeed, attempts have failed in almost all animal expe riments except with the gerbil, and even here experimental designs have been improbable compared with human cholesteatoma. Cholesteatoma in the gerbil is useful, therefore, only for the study of pathology and not for human pathogenesis. I hold that the pathogenesis of cholesteatoma will be understood by studying the cholesteatomatous ear, that is, the malpneumatized ear of the human. The anatomical difference between the normal and malpneumatized ear is a probable cause of cholesteatoma. This difference may be found clinically in facial nerve decompression and cholesteatoma surgery, as, for example, facial nerve palsy occurs usually in the normal, well-pneumatized ear. Of course, conventional animal experimentation will not confirm this clinical difference since there is no ideal animal model for the poorly pneumatized human ear. Present surgical techniques for cholesteatoma vary greatly according to indi vidual otosurgeon's opinion. The most extreme difference of opinion is focused on whether to remove the external ear canal wall. Normally, the best option would be not to remove the canal wall if cholesteatoma recurrence can be prevented. Simply put, recurrence of cholesteatoma comes about when its cause has not been removed during primary surgery.
Master the challenges of cholesteatoma management with this definitive reference Thieme congratulates Eric E. Smouha on being chosen by New York magazine for its prestigious Best Doctors 2015 list. In this succinctly-organized text, leading specialists have created a comprehensive guide to cholesteatoma and chronic ear disease. Based on the bestselling AAO-HNS course, Cholesteatoma provides in-depth advice for the medical and surgical management of this middle ear entity. Cholesteatoma begins with an introduction of the disease and its general considerations, including preoperative assessment, the role of imaging, and the wet ear. Comprehensive chapters then present the three components of middle ear surgery which are the middle ear, the mastoid, and the meatus and the resultant cavity. The expert authors provide perspective on the controversies in cholesteatoma management like canal wall reconstruction, facial nerve monitoring, the use of endoscopes in chronic ear surgery, and postoperative care. Features: Accompanying online media includes 20 surgical videos performed and narrated by the authors More than 340 vibrant full-color illustrations demonstrate the different disease progressions not shown in any other text Insightful chapters cover recidivism and complications of both the disease and surgery, while O.R. cases illustrate surgical approaches Otolaryngology-head and neck surgeons, residents and fellows will refer to this concise reference on a daily basis for the most up-to-date information on cholesteatomas and other middle ear lesions.
Millions of Americans experience some degree of hearing loss. The Social Security Administration (SSA) operates programs that provide cash disability benefits to people with permanent impairments like hearing loss, if they can show that their impairments meet stringent SSA criteria and their earnings are below an SSA threshold. The National Research Council convened an expert committee at the request of the SSA to study the issues related to disability determination for people with hearing loss. This volume is the product of that study. Hearing Loss: Determining Eligibility for Social Security Benefits reviews current knowledge about hearing loss and its measurement and treatment, and provides an evaluation of the strengths and weaknesses of the current processes and criteria. It recommends changes to strengthen the disability determination process and ensure its reliability and fairness. The book addresses criteria for selection of pure tone and speech tests, guidelines for test administration, testing of hearing in noise, special issues related to testing children, and the difficulty of predicting work capacity from clinical hearing test results. It should be useful to audiologists, otolaryngologists, disability advocates, and others who are concerned with people who have hearing loss.
This book aims to provide otolaryngology residents, otology and neurotology fellows, teachers, and young practitioners with comprehensive, up-to-date information on middle ear anatomy that fully meets their needs. It will enable those undergoing surgical training to hone their surgical skills and will assist in ensuring that patients receive appropriate management. The anatomy of the middle ear is explained in easy-to-understand descriptions and exquisitely depicted in more than 100 color photos and numerous helpful color diagrams. Key features of the book are the correlation of clinical situations to the anatomical basis of disease, the simplified explanation of embryology to provide a better understanding of developmental anomalies, and the inclusion of carefully selected CT scans that will assist in the reading of normal anatomy and the identification of pathological features. ​
This comprehensive one-volume work presents, compares and assesses procedures developed by world-renowned otologic surgeons, creating a critical source for the specialist and resident-in-training. Methods from such pioneers as Fisch, Morimitsu, Farrior, and Wullstein are objectively reviewed by Dr. Tos and are integrated into his own vast operative experience. Volume 2 consists of two parts: Part I covers mastoidectomies, intact bridge techniques, and canal wall-up mastoidectomies. Part II covers the reconstructions of the tympanic cavity, attic, and ear canal; eustachian tube surgery; cavity obliteration; and partial and total reconstruction of old radical cavities.
The Oxford Specialist Handbook of Otolaryngology and Head and Neck Surgery is packed full of information which provides an invaluable aid to daily life in ENT practice. It contains comprehensive, practical approaches to subjects, presented in a compact and precise fashion to allow fast, streamlined access to current up-to-date information providing a superb text for education. This book provides an enjoyable way to learn the important aspects of a great medical specialty.