OTOLOGIC CENTER - EAR CARE EXCELLENCE  
Bradley Thedinger, MD
Robert Cullen, MD
Dr Joseph A. Ursick
 
 

Services Offered

SURGICAL

Procedure: Stapedectomy

  • Indications: Otosclerosis with Conductive Hearing Loss
  • Anesthesia: Local or general
  • Surgical Time: 45-60 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: The eardrum is lifted up to evaluate the middle ear. The top of the third bone of hearing (stapes) is removed. A connection is then made between the second bone of hearing (incus) and the inner ear with an artificial piston. The eardrum is draped into its normal position at the end of the procedure.
  • Links: otosclerosis

Procedure: Eardrum Reconstruction (Tympanoplasty)

  • Indications: perforation (hole) of the eardrum
  • Anesthesia: Local or General
  • Surgical Time: 45-90 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: The eardrum is reconstructed with your own tissue taken from the lining of a muscle above your ear or the lining of ear cartilage. A mastoidectomy may be required if chronic infection or cholesteatoma is present
  • Links: chronic otitis media, mastoidectomy

Procedure: Mastoidectomy

  • Indications: Infection, cholesteatoma, chronic otitis media, cochlear implantation, etc.
  • Anesthesia: Local or General
  • Surgical Time: 20-30 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: Using an incision behind the ear, the honey-comb like bone of the mastoid is removed with a special surgical drill. This bone has no function and its removal causes no functional problems.
  • Links: Chronic Otitis Media, Cochlear Implant

Procedure: Middle Ear Reconstruction

  • Indications: Conductive Hearing Loss
  • Anesthesia: Local or General
  • Surgical Time: 30-60 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: A conductive hearing loss may be caused by a problem with the eardrum or one of the three bones of hearing (malleus, incus and stapes). Any or all of these parts may be reconstructed to restore hearing in the majority of patients.
  • Links: hearing loss

Procedure: Tympanostomy Tubes

  • Indications: Chronic middle ear fluid, recurrent ear infections, Eustachian tube dysfunction
  • Anesthesia: General for children, topical (in office) for adults
  • Surgical Time: 5 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: An incision is made in the eardrum to allow air into and fluid out of the middle ear. A small plastic tube is place in the incision to keep it open. The tube naturally falls out in 9-18 months. The eardrum will heal in the vast majority of patients.
  • Links: Eustachian Tube Dysfunction, Hearing Problems in Children

Procedure: Cochlear Implant

  • Indications: Severe to profound hearing loss in both ears
  • Anesthesia: General
  • Surgical Time: 1-2 hours
  • Hospital Admission: Outpatient or Overnight Observation
  • Surgical Procedure: A small incision is made behind the ear and the implant is secured to the skull. A mastoidectomy is performed to gain access to the inner ear. A small hole is made in the cochlea and an electrode is inserted into the cochlea.
  • Links: Cochlear Implant, Sensorineural Hearing Loss, mastoidectomy; Cochlear Website, Advanced Bionics Website, MedEl Website

Procedure: Cholesteatoma Removal

  • Indications: Cholesteatoma (skin cyst)
  • Anesthesia: General
  • Surgical Time: 1-3 hours
  • Hospital Admission: Outpatient
  • Surgical Procedure: Mastoidectomy and Ear Drum Reconstruction are performed to remove this skin cyst. Most cholesteatoma resections require two procedures. The first stage results in removal of the cholesteatoma and reconstruction of the eardrum. A second stage is performed 8-12 months later to ensure complete removal of the cholesteatoma and allows reconstruction of the hearing mechanism.

Procedure: Bone Anchored Hearing Aid (BAHA)

  • Indications: Single Sided Deafness, Conductive Hearing Loss
  • Anesthesia: Local or general
  • Surgical Time: 45 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: A titanium implant is inserted into the bone behind and above the ear. This is very much like a dental implant. After a 3-month healing phase, the sound processor is attached to the implant. This allows sound to pass through the bone of the skull directly to the cochlea.
  • Links: Cochlear website

Procedure: Intratympanic Gentamicin

  • Indications: Meniere’s Disease, unresponsive to medical treatment
  • Anesthesia: Topical
  • Surgical Time: 30 minutes
  • Hospital Admission: Clinic Procedure
  • Surgical Procedure: The eardrum is numbed with a topical medicine. An incision is made in the eardrum and gentamicin is placed into the middle ear. The patient is positioned one side for 30 minutes as the medication perfuses through the membranes of the inner ear. The eardrum heals on its own in a few days. Hearing is preserved in the majority of patients, but some hearing may be lost.
  • Links: Dizziness

Procedure: Intratympanic Steroids

  • Indications: Sudden Hearing Loss
  • Anesthesia: Topical
  • Surgical Time: 30 minutes
  • Hospital Admission: Clinic Procedure
  • Surgical Procedure: The eardrum is numbed with a topical medicine. An incision is made in the eardrum and a steroid is placed into the middle ear. The patient is positioned one side for 30 minutes as the medication perfuses through the membranes of the inner ear. The eardrum heals on its own in a few days.

Procedure: Endolymphatic Sac Surgery

  • Indications: Meniere’s Disease, unresponsive to medical therapy
  • Anesthesia: General
  • Surgical Time: 45-60 minutes
  • Hospital Admission: Outpatient or overnight observation
  • Surgical Procedure: An incision is made behind the ear and a mastoidectomy is performed. Bone overlying the endolymphatic sac is removed. The endolymphatic sac is opened and stented open into the masoid. This allows stabilization of the inner ear fluids.
  • Links: Dizziness

Procedure: Facial Nerve Surgery

  • Indications: Facial weakness, facial nerve injury, infection, tumors
  • Anesthesia: General
  • Surgical Time: 2-4 hours
  • Hospital Admission: 1-4 days
  • Surgical Procedure: The facial nerve takes a winding path on its way through the skull. The facial nerve may be accessed via a mastoidectomy, the middle fossa approach, or other procedures. It may be necessary to remove the boney covering of the nerve (decompression) or reconstruct the nerve (nerve grafting) to improve long-term facial function.

Procedure: Stereotactic Radiosurgery

  • Indications: Acoustic Neuroma, Glomus Tumor, Meningioma
  • Anesthesia: Local
  • Surgical Time: 60-90 minutes
  • Hospital Admission: Outpatient
  • Surgical Procedure: Select patients are candidates for nonsurgical treatment of some disease of the ear and base of skull. Using highly focused beams of radiation, tumors may be treated sparing surrounding structures. The treatment is given in one or multiple sessions.
  • Links: SRS, AN, Cyberknife, Gamma Knife

 

Procedure: Translabyrinthine Surgery

  • Indications: Acoustic Neuroma (Vestibular Schwannoma), Vestibular Nerve Section, Meningioma, Skull Base Tumors
  • Anesthesia: General
  • Surgical Time: 3-5 hours
  • Hospital Admission: Inpatient, 2-4 days
  • Surgical Procedure: An incision is made behind the ear and a mastoidectomy is performed. The inner ear balance canals are removed (labyrinthectomy) resulting in a complete loss of hearing and balance in that ear. Further bone removal is performed, providing exposure to the inner ear canal and the brain cavity. A fat graft is taken from the abdominal wall to seal off the connection between the mastoid and the brain cavity. This prevents leakage of the fluid that surrounds the brain (cerebrospinal fluid).
  • Links: AN, VNS, Dizzy, FN

 

Procedure: Middle Fossa Surgery

  • Indications: Acoustic Neuroma (Vestibular Schwannoma), Vestibular Nerve Section, Meningioma, Skull Base Tumors, Facial Nerve Decompression, Superior Semicircular Canal Dehiscence
  • Anesthesia: General
  • Surgical Time: 3-5 hours
  • Hospital Admission: Inpatient, 2-4 days
  • Surgical Procedure: An incision is made above the ear within the hairline. A small window of bone is removed from the skull to allow access to the brain cavity. The tough lining of the brain (dura) is elevated from the skull. Bone may then be removed from around the inner ear structures and facial nerve. The specific problem may then be treated. Fat from the abdominal wall is used to both fill the space where bone removal was performed and to seal the area preventing leakage of fluid surrounding the brain (called cerebrospinal fluid or CSF). The dura is released allowing it to return to normal position trapping the fat graft in place. The square of bone removed to allow access through the skull is replace and held in place with titanium plates (which allows healing and return to normal structural integrity).
  • Links: AN, VNS, Dizzy, Facial Nerve

 

Procedure: Retrosigmoid/Suboccipital Surgery

  • Indications: AN, VNS, Vascular Decompression, Meningioma
  • Anesthesia: General
  • Surgical Time: 2-5 hours
  • Hospital Admission: Inpatient, 2-4 days
  • Surgical Procedure: An incision is made behind the ear and a square of bone is removed to allow access to the brain cavity. The tough lining of the brain (dura) is opened, allowing access to the structures of the cranial cavity. Retraction of the cerebellum is often required. The lining of the brain is then sutured back together and the square of bone is replaced and held in place with titanium plates. Fat is taken from the abdominal wall to help seal the closure of the brain cavity.
  • Links: AN, VNS, Dizzy,

Procedure: Vestibular Nerve Section

  • Indications: Balance disorders not responsive to medical therapy
  • Anesthesia: General
  • Surgical Time: 2-3 hours
  • Hospital Admission: Inpatient, 2-4 days
  • Surgical Procedure: The balance nerve (vestibular nerve) may be approached with the middle fossa approach, retrosigmoid approach, or translabyrinthine approach. By cutting the balance nerve, abnormal signals coming from the inner ear may be eliminated. Balance compensation occurs by allowing the brain to use normal information from the opposite ear, unhindered by the diseased ear. This allows preservation of hearing in the diseased ear in the vast majority of patients.
  • Links: Dizzy

Procedure: Labyrinthectomy

  • Indications: Balance Disorder unresponsive to medical therapy
  • Anesthesia: General
  • Surgical Time: 1.5-2 hours
  • Hospital Admission: Inpatient 1-3 days
  • Surgical Approach: An incision is made behind the ear and a mastoidectomy is performed. The inner ear balance canals are removed (labyrinthectomy) resulting in a complete loss of hearing and balance in that ear. Balance compensation occurs by allowing the brain to use normal information from the opposite ear, unhindered by the diseased ear. Hearing preservation is not possible with this approach.
  • Links: Dizzy
 

 

 

Make an Appointment
(816) 531-7373


 

 


Otologic Center | 3100 Broadway, Suite 509 | Kansas City, MO 64111
816-531-7373 phone | 816-531-1404 fax