Prof. Dr. Enis Alpin Guneri MD MSc
Otolaryngology Head & Neck Surgery
Laser Stapedotomy
A case of Otosclerosis is treated with the small fenestra stapedotomy technique and piston prosthesis insertion. The surgery is performed with the CO2 laser. Reverse technique is demonstrated here, in which the fenestra on the footplate is created and the piston is inserted before cutting the tendon and removal of the crura.
Endoscopic ossiculoplasty with bone cement
In this right ear, previous ossiculoplasty surgery was unsuccessful to bridge the incudostapedial erosion. A totally endoscopic approach was performed and bone cement was used to reconstruct the defect in the ossicular chain. Note the round window reflex observed by touching the malleus at the end of the surgery, denoting efficient sound pressure transmission into the cochlea.
Endoscopic Laser Stapedotomy
A case of Otosclerosis treated by a small fenestra stapedotomy and teflon piston prosthesis. The surgery is done exclusively with the endoscope through the ear canal with using hand held CO2 laser. The right hand of the surgeon does the surgery while the left hand of the surgeon holds the endoscope.
Facial Nerve Decompression
Temporal bone trauma may lead to a complete facial nerve paralysis which may not resolve after medical and pyhysical treatments. In this case, a transmastoid facial nerve decompression is performed, releasing the pressure on the nerve mainly along its second genu. Note that, after the decompression, the nerve can be electrically stimulated both proximal and distal to the lesion, but the muscle twitch response in the digastric ridge region is weaker with the proximal stimulation.
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