CASE 1/2 SURGEON: Erwin Offeciers (09h15 – 10h30)

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Presentation transcript:

CASE 1/2 SURGEON: Erwin Offeciers (09h15 – 10h30) The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 2 St Augustinus Hospital, Antwerp SURGEON: Erwin Offeciers European Institute for ORL St Augustinus Hospital Wilrijk - Antwerp (Belgium) CASE 1/2 (09h15 – 10h30) TYPE OF SURGERY: Cochlear implant surgery Implantation with Nucleus CI24RE (CA) – LEFT EAR PLANNED SURGERY: Retro-auricular approach. Attico-Antro-Mastoidectomy & posterior tympanotomy. Drilling of the implant bed postero-superiorly. Introduction of the CI. Closure and testing of impedances and NRT.

CLINICAL Female adult °1954 History: The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 2 St Augustinus Hospital, Antwerp CLINICAL Female adult °1954 History: Progressive bilateral hearing loss since > 25 years Family history positive for hearing loss Hearing aids insufficient Otoscopy Normal both sides Erwin Offeciers. Cochlear Implantation. Left ear

VNG: bilateral caloric responses present The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 2 St Augustinus Hospital, Antwerp PURE-TONE AUDIOMETRY ABR – OAE : No response VNG: bilateral caloric responses present Erwin Offeciers. Cochlear Implantation. Left ear

Auditory Phoneme Detection test (70 dB, with HA) LEFT: 11/15 phonemes The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 2 St Augustinus Hospital, Antwerp SPEECH AUDIOMETRY Auditory Phoneme Detection test (70 dB, with HA) LEFT: 11/15 phonemes RIGHT: 14/15 phonemes Auditory Phoneme Discrimination test LEFT: 7/22 contrasts discriminated RIGHT: 14/22 contrasts discriminated Erwin Offeciers. Cochlear Implantation. Left ear

Imaging: MRI & CT LION TV CHANNEL 2 The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 2 St Augustinus Hospital, Antwerp Imaging: MRI & CT Erwin Offeciers. Cochlear Implantation. Left ear

CASE 2/2 SURGEON: Erwin Offeciers (13h30 – 15h00) The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 1 St Augustinus Hospital, Antwerp SURGEON: Erwin Offeciers European Institute for ORL St Augustinus Hospital Wilrijk - Antwerp (Belgium) CASE 2/2 (13h30 – 15h00) TYPE OF SURGERY: CWU with bony obliteration for CSOM with history of pars tensa cholesteatoma SURGICAL TECHNIQUE 1) Retro-auricular approach + harvesting of bone chips & powder 2) Attico-antro-mastoidectomy - CWU 3) Removal of the pathology 4) Closure with bone chips of Tympano-Attical barrier & Post. Tymp. 5) Bony obliteration of attic, antrum and mastoid 6) Reconstruction of ME with tympano-ossicular allograft 7) Closure

Chronic ear LEFT, with developing pars tensa cholesteatoma The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 1 St Augustinus Hospital, Antwerp CLINICAL: Male adult °1978 History: Chronic ear LEFT, with developing pars tensa cholesteatoma Initially followed and cleaned periodically Otorrhea becoming too frequent and bothersome Hearing loss begins to disturb socially Otoscopy: Left perforation-retraction, non self-cleaning Destruction of long process of the incus Erwin Offeciers. Left ear. Pars tensa cholest. Bony Obliteration Technique. Allograft ME rec.

PURE-TONE AUDIOMETRY LION TV CHANNEL 1 The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 1 St Augustinus Hospital, Antwerp PURE-TONE AUDIOMETRY Erwin Offeciers. Left ear. Pars tensa cholest. Bony Obliteration Technique. Allograft ME rec.

MRI & CT Scan (after suction cleaning of the ear) The 8th LION Global Broadcast May 16th, 2013 LION TV CHANNEL 1 St Augustinus Hospital, Antwerp MRI & CT Scan (after suction cleaning of the ear) Erwin Offeciers. Left ear. Pars tensa cholest. Bony Obliteration Technique. Allograft ME rec.