GACEK TRANSCANAL SINGULAR NEURECTOMY//INTRACTABLE P-BPPV скачать в хорошем качестве

GACEK TRANSCANAL SINGULAR NEURECTOMY//INTRACTABLE P-BPPV

Gacek’s singular neurectomy, a procedure used to treat intractable vertigo by targeting the singular nerve. We begin by positioning the patient supine with the head turned slightly to the side. After local anesthesia or general anesthesia is administered, we start with a trans-canal approach. A tympanomeatal flap is carefully elevated to gain access to the middle ear. Next, we identify the round window niche. This is a crucial landmark, as the singular nerve runs just inferior to it. Using a fine drill or curette, we gently remove bone around the round window to expose the area just below it. The singular nerve, which innervates the posterior semicircular canal, is located in this region. Using micro-instruments, we carefully isolate and section the nerve. Precision here is critical to avoid damaging nearby structures, such as the cochlear nerve. After severing the nerve, the surgical site is inspected for hemostasis, and the tympanomeatal flap is repositioned. The canal is then packed with a suitable dressing, and the patient is brought out of anesthesia. Postoperative care involves monitoring for vertigo resolution and any complications like temporary hearing changes or facial nerve issues. This minimally invasive approach provides direct access to the singular nerve with reduced morbidity compared to other techniques.” #nose #ent #science #otolaryngology #ear #nosebleed #throathealth #biology #tonsils #anatomy