Overview of superior canal dehiscence syndrome

endoscopic repair of superior canal dehiscence syndrome

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Overview of endoscopic ear surgery

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PEDIATRIC AND ADULT AUDITORY BRAINSTEM IMPLANT (ABI) FDA CLINICAL TRIAL AT THE MASSACHUSETTS EYE AND EAR INFIRMARY AND MASSACHUSETTS GENERAL HOSPITAL

THE ABI CLINICAL TRIAL WILL INCLUDE INFANTS, CHILDREN AND ADULTS WHO ARE DEAF, DO NOT HAVE NEUROFIBROMATOSIS TYPE 2 AND ARE NOT CANDIDATES FOR THE COCHLEAR IMPLANT

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FOR CURRENT PATIENTS: Are you having surgery by Dr. Daniel Lee? - you can download your post-surgery instructions here.

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ENDOSCOPIC EAR SURGERY COURSES FOR 2015

MARCH 23-25, 2015

ENDOSCOPIC SURGERY OF THE SINUSES, EUSTACHIAN TUBE, AND EAR - MASSACHUSETTS EYE AND EAR INFIRMARY AND HARVARD MEDICAL SCHOOL - registration now open

Course Directors: Ralph Metson MD, Dennis Poe, MD, Stacey Gray, MD, Eric Holbrook, MD, and Daniel Lee MD FACS

With recent advances in endoscopic treatment of disorders of the sinuses, Eustachian tube, and ear, it is imperative that otolaryngologists are up to date on the latest surgical techniques.

The first day of this course will highlight rhinologic topics, including surgery of the skull base, frontal sinus, and orbit.

The second day will focus on treatment of Eustachian tube dysfunction. Balloon dilation techniques of the sinuses and Eustachian tube will be discussed and demonstrated.

The third day will be dedicated to cutting-edge technologies for endoscopic ear surgery.

Learning formats will include lectures, panel discussions, and hands-on dissection laboratory of fresh cadaver specimens by limited subscription.

Dissection will take place in the state of the art Joseph B. Nadol Jr. MD Surgical Training Laboratory at Mass. Eye and Ear Infirmary.

October 2-3, 2015 -

ENDOSCOPIC EAR SURGERY: TWO DAY DISSECTION COURSE - MASSACHUSETTS EYE AND EAR INFIRMARY AND HARVARD MEDICAL SCHOOL- registration now open

Course Directors: Michael Cohen MD and Daniel Lee MD FACS

Endoscopic ear surgery (EES) is an emerging practice in the management of otologic disease. The field of otology is a mature specialty which allows for management of advanced ear disease, primarily relying on direct line-of-sight visualization with a binocular operating microscope. In order to access disease beyond this field of view, healthy bone must be drilled away and soft tissue must be divided and retracted, with secondary tissue trauma.

Advances in endoscopic optics, instrumentation, ergonomics, and surgical technique have enabled surgeons significant advantages in visualization, access, and removal of disease with a substantial reduction in removal or disruption of healthy tissue. In many cases, the traditional postauricular approach can be avoided, with surgery being performed entirely through the ear canal.

This emerging specialty is not yet practiced widely in the United States, however interest is strong and rapidly growing. Our course offers a broad overview of the state of endoscopic ear surgery. Didactic sessions will cover history of EES, extensive discussion of surgical techniques with multimedia content, and strategies for incorporating EES into practice for beginners through advanced practitioners. Hands on sessions in the temporal bone laboratory led by our course faculty will allow participants to experience and practice endoscopic techniques developed at our institution and by surgeons from around the world.

Dissection will take place in the state of the art Joseph B. Nadol Jr. MD Surgical Training Laboratory at Mass. Eye and Ear Infirmary.

October 8-10, 2015 -

MEEI TEMPORAL BONE DISSECTION COURSE - MASSACHUSETTS EYE AND EAR INFIRMARY AND HARVARD MEDICAL SCHOOL

Course Directors: Michael J. McKenna MD, David Jung MD PhD, and Daniel J. Lee MD FACS

There is a growing trend in otolaryngology towards greater sub-specialization, while concurrently there is an increasing shortage of otolaryngologists in the United States.  This course will seek to bring practicing otolaryngologists up to date with the latest techniques in otologic surgery, including chronic ear disease, otosclerosis, vestibular disorders, and endoscopic ear techniques.  MEEI faculty will provide lectures and dissection demonstrations. 

The two first two days will focus on traditional microscopic otologic approaches and the final full day will be dedicated to endoscopic ear surgery.

Under the guidance of MEEI faculty, course participants will perform dissections of fresh temporal bones in the state of the art Joseph B. Nadol Jr. MD Surgical Training Laboratory at Mass. Eye and Ear Infirmary.

Details to be announced shortly.

NOVEMBER 12-15, 2015 -

ENDOSCOPIC EAR SURGERY AND ADVANCED OTOLOGY WORKSHOP

PRACTICAL ANATOMY AND SURGICAL EDUCATION, ST. LOUIS, MISSOURI.

Course Directors: Anthony Mikulec MD and Daniel Lee MD FACS.

This is a dedicated endoscopic ear surgery course for the first two days followed by a basic and advanced temporal bone course with whole skull dissection.

Participants will be able to use the latest surgical technology in the lab - including rigid endoscopes, drills from several manufacturers, middle ear implants and prostheses, KTP and CO2 lasers, and cochlear implant electrodes.

Inner ear surgery techniques, including minimally invasive cochlear implant surgery using the round window insertion approach, and transmastoid and middle fossa craniotomy approaches to repair / resurface superior canal dehiscence will also be presented.

The course takes place at the Practical Anatomy & Surgical Education, Center for Anatomical Science and Education, Saint Louis University School of Medicine, St. Louis, Missouri.

General otolaryngologists, pediatric otolaryngologists, otologists, and neurotologists are welcome.

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Pediatric and adult cochlear implants - an overview of clinical indications for cochlear implants, the multidisciplinary team based at the Massachusetts Eye and Ear Infirmary (MEEI), minimally invasive surgery, titanium screw fixation techniques to avoid tie down holes (especially when the skull is thin in patients 12 months of age or less), basic overview of CI surgery, and what to expect following surgery.

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IMPORTANT UPDATED 2012 GUIDELINES FROM THE CDC FOR COCHLEAR IMPLANT PATIENTS

Meningitis and cochlear implants - although a rare occurrence following CI surgery, it is important that all adult patients receive the correct PNEUMOCOCCAL vaccines and this includes both the Pneumovax and Prevnar 13.

See the CDC recommendations here

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Legislation to improve coverage of pediatric cochlear implant services - State Senator James Eldridge (Massachusetts)

Senator Jamie Eldridge teamed with Dr. Daniel Lee of MEEI and submitted S421 (formerly S469 and H3855), which would require health insurance plans to cover cochlear implant operations and post treatment services for children. Insurance is a major access factor to the CI technology. Please contact your legislator in support of this important piece of legislation to help deaf infants and children of the Commonwealth receive cochlear implant services.

Download the text of MA Senate Bill on pediatric CI coverage here (pdf file)

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NIH study: idiopathic sudden sensorineural hearing loss (SSNHL) multicenter treatment trial is now CLOSED BUT we are still actively caring for patients with sudden single-sided deafness with either high dose oral steroids or intratympanic steroid therapy. Learn more about sudden hearing loss here - www.suddendeafness.org

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superior semicircular canal dehiscence / superior canal dehiscence syndrome - known as Minor syndrome, superior canal dehiscence is a middle fossa skull base defect involving one of the vestibular (balance) organs. Specifically, a tiny hole in the superior (also known as anterior semicircular canal) in one or both ears can cause hearing loss AND/OR imbalance / dizziness, fullness of the involved ear and autophony (echo during self-vocalization). Superior semicircular canal dehiscence (SSCD) or superior canal dehiscence syndrome (SCDS) can result in many symptoms that resemble more common disorders of hearing loss and imbalance like otosclerosis, Eustachian tube dysfunction, patulous Eustachian tube, Menieres disease or BPPV.

Patients who need surgery can undergo repair of SCDS using either a transmastoid or middle fossa craniotomy surgery. The choice of the approach is based on the location of the dehiscence and presence of associated skull base defects.

Case 1 - 27 year old woman with left superior canal dehiscence syndrome (SCDS) who underwent middle fossa craniotomy and SCD repair (video)

Case 2 - 39 year old woman with left superior canal dehiscence syndrome (SCDS) who underwent middle fossa craniotomy and SCD repair (video)

Case 3 - 48 year old man with left superior canal dehiscence syndrome (SCDS) and meningoencephalocele who underwent middle fossa craniotomy, repair of tegmen defect, and repair of bony defect

Case 4 - 15 year old female patient with dizziness and right superior canal dehiscence syndrome (SCDS) from a prominent superior petrosal sinus who underwent transmastoid repair of this less common type of superior canal dehiscence

Case 5 - 27 year old man patient with right ear "near" dehiscence of the superior canal arcuate eminence (blue-lined or thin superior canal) and dural herniation through skull base (tegmen) defect

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