Saturday, March 28, 2009

Head and Neck Cancer Imaging

Head and Neck Cancer Imaging
by R. Hermans
Publisher: Springer Berlin
Published: 2006
ISBN 3-540-22027-5
ISBN 978-3-540-22027-5
Number of pages: 367
In PDF (16,4Mb)
Summary: Mature, sophisticated imaging techniques such as multidetector CT, MRI and PET-CT are now available allowing exquisite morphological display of the extent of the disease in the head and neck region. The radiologist will thus be able to fully assume her/his role as a key member of the multidisciplinary team responsible for the global treatment strategy and the management of the patient with head and neck cancer. This volume offers a comprehensive, detailed, up-to-date review of our current knowledge in the field. The eminently readable text is complemented by numerous and superb illustrations.The editor, R. Hermans, of the radiological department at Leuven University, is a very well known and internationally recognized expert in head and neck radiology who has published widely, especially in the field of head and neck oncology. The authors of the individual chapters were invited to contribute because of their outstanding personal experience in a specific anatomic area and their major contributions to the radiological literature on the topic.
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Sunday, March 22, 2009

A Pocket Guide to the Ear: A Concise Clinical Text on the Ear and its Disorders

A Pocket Guide to the Ear: A Concise Clinical Text on the Ear and Its Disorders by Albert L. Menner
Edition: illustrated
Publisher: Thieme
Published: 2003
ISBN 1588901394, 9781588901392
Number of pages: 145
Summary: The book is based on the author's more than 25 years experience in a thriving ENT practice, and covers everything from proper equipment and examination methods, to anatomy and disorders of each region of the ear. The clear and succinct text is packed with valuable tools you can utilize in daily practice, and cuts through to important truths about ear symptoms, diagnoses, and treatment - information that is not always taught in medical training programs.
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Color Atlas of Otoscopy: From Diagnosis to Surgery

Color Atlas of Otoscopy: From Diagnosis to Surgery
by M.Sanna, A.Russo, G. De Donato, A.Caruso, A.Taibah
Numbert of pages: 224
Publisher: Georg Thieme Verlag
Published: Sept. 2002, 2nd edition
Language: English
ISBN-10: 1588901238
ISBN-13: 978-1588901231
Summary: Atlas of otologic and neurologic diagnosis and treatment. Includes a collection of otoscopic views of a variety of lesions. High-quality, full-color photographs and illustrations. Emphasis is placed on how the view and clinical picture may affect the choice of treatment and surgical technique. For clinicians.
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Saturday, March 21, 2009

Pocket Guide to TNM Staging of Head and Neck Cancer and Neck Dissection Classification

Pocket Guide to
Tnm Staging of Head and Neck Cancer
and Neck Dissection Classification
Publisher:American Academy of Otolaryngology-H&N Surgery
Number of pages: 44
Published: 2008-07
ISBN:1567721176
In PDF (1.2 MB)
Summary:The dweller Head and Neck Society Committee acknowledges the signaling from the Head and Neck Surgery and Oncology Committee and the Head and Neck Surgery Education Committee of the dweller Academy of Otolaryngology–Head and Neck Surgery, and the Council of the dweller Head and Neck Society. Appreciation is also long to politico Denys, MD, for the illustrations and the AJCC for the ingest of production aggregation from the 6th editionof the AJCC person Stating Manual.This monograph has been endorsed by the dweller Head and Neck Society and The dweller Academy of Otolaryngology– Head and Neck Surgery.
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Atlas of Clinical Oral Pathology

Atlas of Clinical Oral Pathology
by Young and Sedano
Publisher:Univ of Minnesota Press
Number of pages:236
Published: June 1981
ISBN:0816610401
In PDF (7.9 MB)
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Obstructive Sleep Apnea: Pathophysiology, Comorbidities and Consequences

Obstructive Sleep Apnea
Pathophysiology, Comorbidities and Consequences
Publisher:Informa HealthCare
Number of pages:504
Published: 2007-05-17
ISBN:084939106
In PDF (4.2 MB)
Summary: Responding to the ontogeny acceptance of Obstructive Sleep Apnea (OSA) as a field scrutiny information and the beginning of elating newborn therapies, this maker analyzes the clinical features, characteristics, comorbidities, and effect of OSA on enduring natural systems and quality-of-life. Edited by the Director of the Center for Human Sleep Research at Stanford, this maker supplies an all-encompassing pass to the comorbid scrutiny conditions and socioeconomic effect of OSA.
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Contemporary Oral and Maxillofacial Surgery

Contemporary Oral and Maxillofacial Surgery (4th Edition)
by Peterson, Ellis, Hupp, Tucker
Publisher:Mosby
Number of pages:800
Published: 2002-12-05
ISBN:0323018874
In PDF & LIVE Videos (529 MB)
Summary: In an easy-to-follow, highly illustrated approach, this favourite book presents the base principles of preoperative and scrutiny direction of test surgery problems. This well-organized book defines the persona of the generalized dentist as a member of the preoperative direction team. Basic techniques of evaluation, diagnosis, and scrutiny direction are presented in definitive discourse that allows the reverend to directly administer these methods to practice. It provides aggregation on the base test surgery procedures that the generalized practician encounters, as substantially as an overview of test and maxillofacial surgery procedures performed by the specialist. All preoperative techniques are substantially illustrated so readers crapper alter key preoperative concepts. * Authored by well-known, reputable practitioners and contributors in the earth of OMS, art on their riches of clinical expertise.* Two-color info highlights key concepts and makes aggregation cushy to follow.* Appendices wage priceless meaning sections, including multipurpose examples of prescriptions, postoperative instructions, an conversant respond form, and underway helper pricing. * A newborn chapter focuses on facial tasteful surgery, which is ofttimes included in a broad communication organisation to hands restorative, prosthetic, and orthodontic treatment.* Basic and modern preprosthetic procedures hit been compounded into digit rank chapter so readers crapper easily invoke to procedures of interest.* Enhanced and reinforced illustrations throughout more accurately exposit key concepts and techniques, and some photos hit been replaced with new, high-quality images.* The chapter on facial neuropathology has been completely revised to inform the most up-to-date aggregation on this topic.
You module requirement Adobe 5.0 or after & Quick Time installed in visit to wager the Videos!
OR
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Advanced Therapy of Otitis Media

Advanced Therapy of Otitis Media
by Alper, Bluestone, Casselbrant, Dohar, Mandell
Publisher:BC Decker Inc.
Numer of pages: 554
Published: 2003-11-01
ISBN:1550092014
In PDF (14 MB)
Summary: Advanced Therapy of Otitis Media provides answers to clinical tending questions from the most ordinary problems to thin complications and sequelae of otitis media. The aggregation targets clinicians who verify tending of patients with a difference of otolaryngological presentations every day. Each chapter in the aggregation focuses on an move to a limited clinical topic; characteristic technique; therapeutic method; complexness attendant question; or controversy. The chapters exposit the subject, incidence, importance, etiology/pathogenesis, and direction options.

http://www.filefactory.com/file/1167a0/n/0418_AdvOtitisM_rar http://www.megaupload.com/?d=L98LE80F http://rapidshare.com/files/144022499/0418_AdvOtitisM.rar

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Pediatric Sinusitis and Sinus Surgery

Pediatric Sinusitis and Sinus Surgery
by Ramzi T. Younis
Publisher:Informa HealthCare
Number of pages:296
Published: 2005-09-26
ISBN:0824728815
In PDF (2.8 MB)
Summary: Comprehensively addressing the different aspects of canal disease in children, this meaning describes the whole spectrum of medicine sinusitis management, surgery, and control-opening with sections on morphology and pathophysiology; demonstrating approaches in characteristic work-up and scrutiny therapy; detailing preoperative management; and considering topics much as sinusitis complications, comorbidity, tonsillectomy, adenoidectomy, cystic fibrosis, and allergy or insusceptible deficiency; this pass is a stand-alone maker for anyone participating in medicine canal disease.
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Operative Techniques in Laryngology

Operative Techniques in Laryngology
by Clark A. Rosen, C. Blake Simpson
Publisher:Springer
Number of pages:312
Published: 2008-10
ISBN:354025806X
In PDF (18.5 MB)
Summary: Operative Techniques in Laryngology fills a vacuum that currently exists in medicine textbooks: a broad book on laryngeal surgery that crapper be utilised by physicians to educate for preoperative cases. It contains definitive step-by-step descriptions of preoperative procedures much that the reverend crapper “learn to operate”. The preoperative pillar is cursive by well-known experts with step-by-step preoperative maneuvers for different laryngeal procedures include both microlaryngeal surgery and laryngeal support surgery. Postoperative tending and complications are also awninged to ammo discover the aggregation necessary by the doc in the perioperative period. The pillar is extravagantly illustrated with photographic representations of every preoperative steps and superior graphics illustrations to particular the arduous three-dimensional body concepts. In summary: This unequalled pass filled with “cookbook” descriptions of laryngeal preoperative procedures provides a hurried and ultimate meaning for every surgeons fascinated in laryngological surgery.
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Principles and Practice of Head and Neck Oncology

Principles and Practice of Head and Neck Oncology
Publisher:Informa Healthcare
Number of pages:648
Published: 2003-03-27
ISBN: 1899066063
In PDF (31 MB)
Summary: Increased noesis of transmitted and medicine factors, excellence of the tools of diagnosis, greater discernment of clinico-pathological correlation, and advances in rehabilitation and recollection are meet a some of the developments that hit condemned locate in the think and communication of nous and cervix cancer during the time digit centuries. Written by a multidisciplinary commission of experts, Principles and Practice of Head and Neck Oncology provides a broad, comprehensive, and counterpoised analyse of the underway technological noesis and direction of nous and cervix tumors. Taking a multidisciplinary approach, the aggregation covers every aspects of treatment, from initial characteristic procedures, finished staging, surgery, radiation, and chemotherapy to aftercare and rehabilitation. It explores the complexities of managing this rattling different assemble of diseases. The mass sections analyse apiece of the field types of cancer: tumors of the bunk airways and digestive biome (including the mouth, nasopharynx and larynx), and the skull humble tumors, endocrine and salivary glands. The holistic approach, contributions from experts, and more than 500 illustrations, most in color, attain the aggregation an essential inventiveness for nous and cervix oncologists at every level.
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Cleft Lip and Palate: From Origin to Treatment

Cleft Lip and Palate: From Origin to Treatment
by Diego F. Wyszynski
Publisher: Metropolis University Press, army
Number of pages: 548
Published: 2002-08-01
ISBN: 0195139062
In Chm (32 MB)
Summary: Majoradvances in the identification and communication of test clefts hit been prefabricated in the time 50 years, and past biology and penalization studies hit led to newborn theories most the causes of divided lip and palate. Addressing issues that are germane to clinicians, researchers and familymembers, this aggregation is a comprehensive, well-illustrated, and up-to-date statement of the some facets of this ordinary disorder. The authors exposit the embryological and molecular mechanisms of divided causation, inform and elaborate the transmitted and penalization methods utilised to refer riskfactors for test clefts, and exposit treatments by the different professionals of the divided team. A country is also devoted to the combining of investigate findings into open upbeat practice, including right and business considerations. The aggregation draws unitedly much different disciplines ascraniofacial development, factor mapping, epidemiology, medicine, ethics, upbeat economics, and upbeat contract and management, and it module be an valuable meaning work.
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Surgery of the Thyroid and Parathyroid Glands

Surgery of the Thyroid and Parathyroid Glands
by Daniel Oertli and Robert Udelsman
Publisher: Springer
Number of pages: 354
Published: 2007-01-01
ISBN: 3540291652
In PDF (23 MB)
Summary: The intend of this book is to create a unequalled in-depth broad meaning concealment every surgically germane endocrine and endocrine diseases. It is a defined meaning presenting the stylish aggregation on the direction of ordinary and thin disorders of the endocrine and endocrine glands. International polity wage careful discussions on functioning techniques and treatments that are attended by rationales for portion approaches advocated by the authors. The topics allow the statement of every surgically germane pathologies, the preoperative preoperative evaluation, selection making, and functioning strategies for the assorted endocrine and endocrine diseases. In addition, experts inform the molecular foundation for endocrine neoplasia and the underway discernment of the biology of inherited endocrine and endocrine diseases. Evolving recent functioning techniques same the minimally intrusive videoscopic move to the endocrine and parathyroids are also covered.

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Friday, March 20, 2009

Vertigo and Dizziness

Vertigo and Dizziness
by Thomas Brandt, Marianne Dieterich, Michael Strupp
Publisher:Springer
Number of pages: 208
Published: 2005-02-28
ISBN:1852338148
In PDF (2.48 MB)
Summary: After headache, vertigo and symptom is the ordinal most ordinary upset of patients. Vertigo is not a disease entity, but kinda an general syndrome consisting of assorted disorders with assorted causes. Most syndromes of vertigo crapper exclusive be aright diagnosed by effectuation of a certain scrutiny story and fleshly communicating of the patient. The eld of these cases hit a harmless cause, a approbatory uncolored course, and a constructive salutation to therapy.
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Thursday, March 19, 2009

Cummings Otolaryngology: Head and Neck Surgery (4th Edition)

Cummings Otolaryngology: Head and Neck Surgery (4th Edition)
by Charles W. Cummings, Bruce H. Haughey, J. Regan Thomas,
Lee A. Harker, Paul W. Flint
Binding: Hardcover
Numer of pages: 4192
Publisher: Mosby
Edition: 4th edition (Nov.04)
Language: English
ISBN-10: 0323019854
ISBN-13: 978-0323019859
Summary: This masterwork is universally acknowledged as the most comprehensive, authoritative reference in the field ofotolaryngology - head and neck surgery. Its four volumes encompass the entire body of core knowledge as well as the most cutting-edgedevelopments within every otolaryngologic subspecialty. A multitude ofpreeminent contributing experts ensure that the coverage is complete, up to date, and clinically relevant. This 4th Edition features significant changes to the editorial team as well as sweeping updates to reflect all of the latest advances in basic science and clinicalpractice. Plus, all of the illustrations from the 4-volume set areincluded in a bonus CD-ROM bound into the book!
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The Temporal Bone: A Manual for Disection and Surgical Approaches

The Temporal Bone
(A Manual for Disection and Surgical Approaches)
by Mario Sanna, Tarek Khrais, Maurizio Falcioni,
Alessandra Russo, Abdelkader Taibah
Publisher: Thieme Medical Pub
Published: 11 August, 2006
Number of pages: 146
ISBN: 1588903834
Summary: The anatomy of the temporal bone is one of the most complicated areas in the human body. The vital structures, the three-dimensional relationships involved, and the fact that these structures are hidden within bony canals make the anatomy difficult to grasp. To add to the complexity, any pathology affecting the area generally leads to some degree of alteration of the anatomy. For this reason, it is essential for any physician interested in otology, neurotology, or skull-base surgery to be perfectly familiar with the anatomy.Described as a dream come true by the authors, Professor Sanna and his colleagues have devoted a major effort to creating this book to serve as a guide for young trainees wanting to learn more about temporal bone dissection. It provides comprehensive, high-quality, full-color pictures of the detailed steps of all the major surgical approaches that can be performed in the temporal bone, supplemented by images of cadaveric dissections as an aid to understanding the intracranial anatomy when indicated by the approach.
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Atlas of Otologic Surgery

Atlas of Otologic Surgery
by Marcos V. Goycoolea, Michael M. Paparella & Rick L. Nissen
Publisher: W.B. Saunders Company
Number Of Pages: 392
Publication Date: 1989-01
ISBN-10 / ASIN: 0721623379
ISBN-13 / EAN: 9780721623375
Binding: Hardcover
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Ballenger's Manual of Otorhinolaryngology Head and Neck Surgery (16th Edition)

Ballenger's Manual of Otorhinolaryngology Head and Neck Surgery
by James B. Snow Jr.
Number of pagess: 640 pages
Publisher: B.C. Decker; Sept. 2002
Language: English
ISBN-10: 1550091999
ISBN-13: 978-1550091991
File size: 8.06 Mb
Summary: Ballenger's Manual Otorhinolaryngology Head and Neck Surgery, 16th Edition presents synopses of 47 chapters of the aggregation that come clinical problems, identification and management. These clinically familiarised synopses wage aggregation on the commonly encountered problems in otology/neurotology, rhinology, facial impressible and constructive surgery, medicine otorhinolaryngology, laryngology, nous and cervix surgery and bronchoesophagology. The noesis reflects the bicentric domain of the otorhinolaryngology in treating patients with diseases moving the senses of smell, discernment and equilibrise and in the disorders of manlike act moving hearing, voice, style and language.
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Wednesday, March 18, 2009

Ballenger’s Otorhinolaryngology Head and Neck Surgery (16th Edition)

Ballenger’s Otorhinolaryngology
Head and Neck Surgery (16th Edition)
by James B. Snow, Jr. and John Jacob Ballenger
Publisher:BC Decker, Inc.
Hamilton, Ontario, Canada,
Publication : 16th Edition, 2003
Number of pages: 1616
Language: English
ISBN-10: 1550091972
ISBN-13: 978-1550091977
Summary: This edition of "Ballenger's Otorhinolaryngology Head and Neck Surgery" continues in the tradition of being a comprehensive compendium of current knowledge in the fields of otology/neurotology, rhinology, facial plastic and reconstructive surgery, pediatric otorhinolaryngology, head and neck surgery and bronchoesophagology. New sections on facial plastic, reconstructive surgery and paediatrics round out the update content to all 67 chapters. The content reflects the central responsibility of the otorhinolaryngologist in treating patients with diseases affecting the senses of smell, taste and balance. Also, encompassed in this section are treatments for disorders of human communication affecting hearing, voice, speech and language. The presentation of basic science underlying clinical otorhinolaryngology head and neck surgery has expanded to provide the most comprehensive coverage. Structured to provide current and meaningful content the chapters on clinical topics will meet the needs of practitioners in the 21st century.
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Operative Techniques in Otolaryngology - Head and Neck Surgery

Operative Techniques in Otolaryngology
Head and Neck Surgery
By W.B. Saunders
Publisher: Wb Saunders Co/Fulfillment Dpt
Number Of Pages: 1400
Publication Date: . December 2003 - December 2007
ISBN-10 / ASIN: B00006KRHD
ISBN-13 / EAN:
Binding: Magazine
Summary: Contains articles on complications, diagnosis treatment or rehabilitation as well as new techniques that are non-operative.
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Imaging of the Head and Neck

Imaging of the Head and Neck
Publisher: Thieme Georg Verlag
Number Of Pages: 880
Publication Date: 2004-10-31
ISBN-10 / ASIN: 313100942X
ISBN-13 / EAN: 9783131009425
Binding: Hardcover
Summary: The successor to Head and Neck Imaging has been completely updated to cover advances in the field. The key features of this book are: organization according to anatomic regions; extensive illustrations to help the reader distinguish between normal and pathologic findings; correlates imaging findings to sections from cadavers; extended chapter on MRI and MRA techniques in the temporal bone; new chapter on the orbit and globe; new material on the anatomy and pathology of the paranasal sinuses for functional endoscopic surgery; state-of-the-art approaches to neck pathology. It is an excellent reference book for both experienced practitioners and residents.
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The Sinus Sourcebook

The Sinus Sourcebook
Publisher: Lowell House
Number Of Pages: 191
Publication Date: 1998-05
ISBN-10 / ASIN: 1565656431
ISBN-13 / EAN: 9781565656437
Binding: Hardcover
Summary: Every year, millions of people go into their doctors’ offices complaining of “sinus trouble, ” but does this necessarily mean they have sinusitis? The Sinus Sourcebook clears up the confusion around the disease and thoroughly explains the treatments available for a wide range of sinus maladies.
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Auditory Trauma, Protection, and Repair

Auditory Trauma, Protection, and Repair
Publisher: Springer
Number Of Pages: 352
Publication Date: 2008-03-19
ISBN-10 / ASIN: 0387725601
ISBN-13 / EAN: 9780387725604
Summary: The past decade has brought great advances in our understanding of the mechanisms underlying auditory pathologies. Molecular biology and genetics have primarily contributed to this enhanced understanding, which in turn has driven the design of novel rational therapeutic interventions. Auditory Trauma, Protection and Repair presents recent developments in auditory research and their potential translation to the clinical setting. In particular the authors address the major entities of peripheral auditory trauma, discuss the underlying mechanisms, the central nervous system consequences, protective interventions and finally explore the possibilities to restore cochlear morphology and function.
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Computer-Aided Otorhinolaryngology - Head and Neck Surgery

Computer-Aided Otorhinolaryngology-Head and Neck Surgery
by M.Citardi
Publisher: Informa HealthCare
Number Of Pages: 504
Publication Date: 2001-12-12
ISBN-10 / ASIN: 0824706412
ISBN-13 / EAN: 9780824706418
Product Description: Cleveland Clinic Foundation, OH. Focuses on the applications of semiconductor-based technologies within clinical otorhinolaryngology - head and neck surgery. Recognizes current challenges and technological limitations and proposes solutions and strategies based on semiconductor-derived systems. Also presents visions for the future. For practitioners.
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Tuesday, March 3, 2009

Operative Techniques in Otolaryngology - Head and Neck Surgery (Vol 19)

Operative Techniques in Otolaryngology - Head and Neck Surgery
Minimally Invasive Head and Neck Surgery
Volume 19, Issue 1
Author: Timon MB, FRCSORL, MD
Publisher: Elsevier
Published: March 2008
ISSN (printed): 1043-1810
Summary: This large-size, atlas-format journal presents detailed illustrations of new surgical procedures and techniques in otology, rhinology, laryngology, reconstructive head and neck surgery, and facial plastic surgery. Feature articles in each issue are related to a central theme by anatomic area or disease process. The journal will also often contain articles on complications, diagnosis, treatment or rehabilitation. New techniques that are non-operative are also featured.
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Atlas of Acoustic Neurinoma Microsurgery

Atlas of Acoustic Neurinoma Microsurgery
By M. Sanna
Publisher: Georg Thieme Verlag
Number Of Pages: 211
Publication Date: 1998-01
ISBN-10 / ASIN: 3131102810
ISBN-13 / EAN: 9783131102812
Binding: Hardcover

This colour atlas provides information on all major acoustic neurinoma procedures, and is designed to improve physicians' skills in this specialty. With more than 50,000 new cases per year worldwide, acoustic neurinomas are among the most commonly observed skull-base tumours. They are also among the most demanding for surgeons, since great precision is needed to safeguard the auditory nerve, the facial nerve and other critical structures. The book begins with sections on the radiographic assessment of tumours, the selection of surgical approach, and pre-operative preparations. It then turns to the main surgical approaches, using hundreds of photographs - taken during actual surgery - to lead readers through each procedure in step-by-step detail. There is a special section on the use of endoscopy in acoustic neurinoma surgery, and an analysis of 50 MR scans. This practical volume should be of interest to otolaryngologists, neurosurgeons and other physicians involved in acoustic neurinoma surgery.

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Sunday, March 1, 2009

Head and Neck Surgery — Otolaryngology

Head and Neck Surgery — Otolaryngology
By Poet J Bailey, Jonas T Johnson, Choreographer D Newlands,
Karenic H Calhoun, Ronald W Deskin, etc.
Publisher: Lippincott reverend & Wilkins
Number Of Pages: 3024
Publication Date: 2006-04-01
Sales Rank: 80457
ISBN / ASIN: 0781755611
EAN: 9780781755610
Binding: Hardcover
Summary:Newly revised and updated, this comprehensive, easy-to-use two-volume penalization book is today in its Fourth Edition. solon than 30 newborn chapters are included that emit advances in the field, much as outcomes and evidence-based medicine, preoperative direction of bone regulator founder and choanal atresia, immunology and allergy, hypersensitised and non-allergic rhinitis, complications of rhinosinusitis, direction of dysphagia, radiographic communicating of the bunk aerodigestive tract, endoscopic assessment of the bunk aerodigestive tract, aesthetical uses of Botox, and more. Coverage includes both grown and medicine otolaryngology. All chapters are cursive by important world-renowned polity and include unofficial highlights boxes, unofficial tables, and end-of-chapter reviews. solon than 2,500 illustrations hands the text.
File in .rar in 3 parts (97 + 97 + 93 MB)
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Tuesday, January 20, 2009

OTOSCLEROSIS - STAPEDECTOMY

What is Otosclerosis? Otosclerosis is a condition in which new and unwanted bony tissue is formed in the bone which surrounds the inner ear. This new bone contains many blood vessels and is rather less hard than normal bone. Gradually the new bone matures and becomes hard (sclerotic). Less than 1% of the population is affected by this condition. Deafness is the main symptom and is usually present in both ears. Most patients notice the deafness before the age of 50. Noises in the ear (tinnitus) are present in most cases. A few patients may have some slight unsteadiness but this is rarely severe. Pain and discharge from the ears are not features of otosclerosis. How does Otosclerosis occur? Normal hearing is the result of sound waves in the outer ear being converted to nerve signals to the brain. The sound energy vibrates the ear drum. The drum vibrates three little bones in the middle ear which conduct the sound to the inner ear. These little bones are called the malleus, incus and stapes. It is the stapes which connect to the inner ear in a bony gap called the oval window. In otosclerosis the formation of new bone around the oval window stops the stapes from moving. This produces the deafness. In normal hearing it is movement of the stapes which stimulates the nerve endings in the inner ear to produce signals which go to the brain. In a small number of cases the new bone also interferes with the function of the inner ear (cochlea). This inner ear damage also produces deafness. Why does Otosclerosis occur? The cause of otosclerosis is unknown. Pregnancy sometimes makes the hearing worse in otosclerosis. It is for this reason that the condition is thought to be sometimes related to hormone levels. Otosclerosis tends to run in families. For these reasons it is thought that there is a hereditary or genetic basis for the disorder. Treatment involved for Otosclerosis Usually a hearing aid can be used with good effect. A hearing aid will be prescribed for those who are either too young or too old for surgery. There can be other reasons for not operating, such as poor health. Children are not usually offered surgery because they are more liable to frequent ear infections and may have congenital abnormalities of the ear, which make the operation less successful. The operation should never be done on the only ear with useful hearing. Infection of the outer ear is also a reason to avoid surgery. The operation which is done for otosclerosis is called a stapedectomy . STAPEDECTOMY is usually done under general anaesthetic. It is performed using an operating microscope and the approach is through the ear canal. The ear drum is lifted out of its groove with an attached flap of skin. The middle ear can then be examined and the diagnosis confirmed visually. The purpose of the operation is to replace the fixed stapes bone with a substitute which can move. Usually, part of the fixed base and the stapes is removed, and an artificial bone replacement is put into position. The "prosthesis" may be made of non-reactive plastic or other material. Usually one end is hooked over the incus and the other is placed in the opening in the stapes foot plate. Possible complications The manipulation of the stapes always produces a reaction in the inner ear. This shows itself as a degree of giddiness and possibly hearing loss. In 90% of cases the results of stapedectomy are very good. In a small percentage of cases there may be severe or total loss of hearing in the operated ear. This may occur immediately after surgery or be delayed for several years. For this reason it is usual not to operate on the second ear without a gap of several years. In about 10% of cases the hearing is only slightly improved or there is no improvement. The facial nerve which supplies the muscles of the face runs through the middle ear. This nerve is occasionally damaged, producing a lop-sided weakness of the face. Another nerve called the chorda tympani supplies the sense of taste. This nerve is frequently damaged. This results in a temporary metallic taste which does not usually cause any significant problem. Giddiness with loss of hearing and tinnitus may occur some time after surgery. This may be due to a leakage of fluid around the artificial stapes. This condition is called a perilymph leak and requires a further operation on the ear. Infections of the middle ear are very rare after stapes surgery but are treated very promptly when they do occur. After Treatment Immediately after surgery you will feel unsteady through varying degrees. Pain is not a problem after stapedectomy. Movement of the head will make you feel giddy. During the first day, patients are nursed in bed and moving of the head discouraged. Drugs are given by injection to prevent giddiness. You will be warned not to blow the nose. From the second day, you will be slowly mobilized and the injections are usually changed to treatment by mouth. On the third day, and provided you are not unduly unsteady, you may be discharged home. Usually the ear canal dressing is removed before leaving hospital. Sometimes ear drops or antibiotics may be prescribed. After surgery you will be seen as an outpatient. In some cases stitches may have been placed in the ear and these need to be removed. Hearing improvement is not measured until at least 3 weeks after surgery. Most patients are able to return to work in the third or fourth week. If you get severe pain, discharge or marked unsteadiness after leaving hospital, you should report the problem to the surgeon or his staff. The surgeon will want to follow up the result of stapedectomy at intervals for several years. You are advised to avoid pressure changes wherever possible. This means not swimming deeply underwater or diving. Flying should be avoided when you have a cold. Stapedetomy - The surgical Procedure