MODERATORS: LION CHANNEL 1 Cor Cremers (The Netherlands) Wilko - PowerPoint PPT Presentation

(08h30) MODERATORS: LION CHANNEL 1 Cor Cremers (The Netherlands) Wilko Grolman (The Netherlands) John Oates, Birmingham (UK) WELCOME & OPENING REMARKS

SURGEON: LION TV 1 : 08h30 – 10h30 Rolf Salcher University Medical School Hannover (Germany) CARINA (Cochlear) fully implantable hearing aid (Case presentation will be made online)

SURGEON: LION TV 1 : 08h30 – 10h30 Thomas Lenarz University Medical School Hannover (Germany) MED-EL Vibrant Soundbridge insertion with round window coupling using precision coupler (Case presentation will be made online)

SURGEON: LION TV 1 : 09h00 – 09h30 Robert Vincent Causse Ear Clinic Colombiers (France) Otosclerosis primary surgery (Left ear) – Transcanal approach Combined Lumenis OtoLase hand-held CO2 laser and microdrill stapedotomy with vein graft interposition Ossiculoplasty with Causse Teflon piston

Clinical history: 34 yr-old female Left progressive hearing loss since few years without tinnitus nor dizziness No family history of deafness Personal history negative Otoscopy normal and tuning fork lateralized towards the left ear

Audiometry:

SURGEON: LION TV 1 : 98h30 – 10h00 Robert Vincent Causse Ear Clinic Colombiers (France) Otosclerosis primary surgery (left ear) – Endaural approach

Clinical history: 36 yr-old female Reduced hearing since 2005 Right stapes surgery in 2009 (external clinic) Speech comprehension reduced in the last years

Audiometry: speech audiometry pure tone audiometry

SURGEON: LION TV 1 : 10h30 – 12h30 Thibaud Dumon Causse Ear Clinic Colombiers (France) Tympanoplasty for progressive unstable retraction pocket (Left ear) Canal wall up technique

Clinical history: Left ear: hearing loss, tinnitus, ear fulness sensation • Left tympanoplasty 1992, 2016 • Eustachian tube balloon dilatation 2018 • Otoscopy: - left ear: recurent attic retraction pocket • Audiogram: - left ear: mild mixed HL •

Audiometry: Audiogramme Tonal : Oreille droite Audiogramme du 08/10/2018 Audiogramme Tonal : Oreille gauche 125 250 500 1000 2000 4000 8000 125 250 500 1000 2000 4000 8000 -10 -10 0 0 10 10 20 20 30 30 40 40 50 50 60 60 70 70 80 80 90 90 100 100 110 110 120 120 Pam OD CA : 9 db OD CO : 4 db Pam OG CA : 22 db OG CO : oreille droite Réflexe stapédien oreille gauche Tympan gauche Tympan droit 10 10 500 1000 2000 4000 500 1000 2000 4000 8 8 6 6 contro 4 4 Tympanogramme : Oreille droite Tympanogramme : Oreille gauche 2 ipsi 2 0 0 Effet on off -2 -400 -300 -200 -100 0 100 200 -2 -400 -300 -200 -100 0 100 200 10 10 250 500 1000 2000 4000 8000 Weber 8 8 Audiogramme Vocal 100 % 6 6 f m F Score de reconnaissance vocale 4 4 50 % 2 2 0 0 0 % 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 105 110 -400 -300 -200 -100 0 100 200 -400 -300 -200 -100 0 100 200 Niveau d'audition dB HV

CT scan:

SURGEON: LION TV 1 : 10h45 – 11h30 Chris Aldren Wexham Park Hospital Slough (UK) Ossiculoplasty, primary surgery for epitympanic malleus ankylosis (Right ear) Removal of incus, malleus relocation KURZ partial clip placement from stapes head to tympanic membrane with cartilage interposition

Clinical history: Female aged 28 Recurrent acute otitis media in childhood Decreased hearing right ear for >4 years Intermittent high pitched tinnitus Tried hearing aid which she does not like

Audiometry: Right AC 38dB ABG 20dB Left AC 6dB ABG 5dB

Imaging: Fixed malleus

SURGEON: LION TV 1 : 12h30 – 14h00 Rolf Salcher University Medical School Hannover (Germany) MED-EL partial insertion cochlear implantation in patient with high frequency deafness (Case presentation will be made online)

SURGEON: LION TV 1 : 12h30 – 14h00 Nils Prenzler University Medical School Hannover (Germany) Hearing preservation AB slim cochlear implantation with cochlear monitoring (EcochG) (Case presentation will be made online)

SURGEON: LION TV 1 : 12h45 – 13h30 Robert Vincent Causse Ear Clinic Colombiers (France) Ossicular reconstruction, revision surgery (Right ear) – Transcanal approach Revision following two previous failed surgeries

Clinical history: 21 yr-old female. Long-term history of repeated otitis since childhood - First previous failed right tympanoplasty (other surgeon) in 2005 with partial ossicular chain reconstruction (PORP): immediate failure - Right revision operation (R Vincent) in 2007. Middle ear exploration revealed a dislocated PORP and ossiculoplasty was performed with a 6.25mm length TORP (malleus-to-footplate). Malleus relocation was performed but silastic banding technique was not possible due to the presence of a stapes which was abnormally bent towards the promontory: Good and stable result for several years followed by progressive recurrent right HL - Right revision operation (R Vincent) in 2012 showing TORP dislocation. A new TORP was inserted (same length): Good and stable result for several years followed by progressive recurrent right HL

Audiometry:

SURGEON: LION TV 1 : 14h00 – 15h30 Magnus Teschner University Medical School Hannover (Germany) Neuro Zil (OTICON) cochlear implantation (Case presentation will be made online)

SURGEON: LION TV 1 : 12h30 – 14h00 Franco Trabalzini Meyer Children’s Hospital Florence (Italy) Med-EL cochlear implantation in children (right ear)

Clinical history: 8 yr-old male. Congenital progressive bilateral hearing loss (bilateral enlarged vestibular acqueduc( Left cochlear implantation in 2015 Otoscopy: normal

Audiometry:

CT-Scan:

SURGEON: LION TV 1 : 14h15 – 14h45 Chris Aldren Wexham Park Hospital Slough (UK) Otosclerosis primary surgery – Transcanal approach (Right ear) Canal wall up technique

Clinical history: Female 29 years. History of bilateral progressive conductive hearing loss Bilateral buzzing tinnitus Blue sclera No family history of hearing loss

Audiometry: Right AC 55dB ABG 25dB Left AC 66dB ABG 26dB

CT scans: Bilateral otosclerosis

SURGEON: LION TV 1 : 14h45 – 15h15 Robert Vincent Causse Ear Clinic Colombiers (France) Otosclerosis revision surgery (Left ear) – Transcanal approach Revision stapedectomy with Lumenis hand-held OtoLase fiber laser and micro-drill. Ossicular reconstruction according to the cause of failure and status of the ossicular chain (incus)

Clinical history: 61 yr-old male. Bilateral progressive hearing loss over time Left failed stapedectomy in 2005 (other surgeon) Right primary stapedotomy with vein graft interposition (R Vincent) one year ago with good and stable result

Audiometry:

SURGEON: LION TV 1 : 15h30 – 16h30 Rolf Salcher University Medical School Hannover (Germany) MED-EL Bonebridge implantation (Case presentation will be made online)

SURGEON: LION TV 1 : 15h30 – 16h30 Thibaud Dumon Causse Ear Clinic Colombiers (France) PONTO (OTICON) bone anchored hearing aid insertion MIPS (Minimally Invasive Ponto Surgery) Punch technique, no soft tissue reduction, no associated incision

Clinical history: Bilateral progressive mixed hearing loss. • Left tympanoplasty 1998, 2005 (other surgeon) • Otoscopy: - left ear: stable lateralized TM • - right ear : fibro adhesive otitis Audio: - left moderately severe mixed HL • - right moderate mixed HL

Audiometry: Madame SALVI Marie né(e) le 06/08/1953, 65 ans Dr DUMON Audiogramme Tonal : Oreille droite Audiogramme du 02/11/2018 Audiogramme Tonal : Oreille gauche 125 250 500 1000 2000 4000 8000 125 250 500 1000 2000 4000 8000 -10 -10 0 0 10 10 20 20 30 30 40 40 50 50 60 60 70 70 80 80 90 90 100 100 110 110 120 120 Pam OD CA : 49 db OD CO : Pam OG CA : 60 db OG CO : Tympan gauche oreille droite Réflexe stapédien oreille gauche Tympan droit 10 10 500 1000 2000 4000 500 1000 2000 4000 8 8 6 6 contro Tympanogramme : Oreille droite 4 4 Tympanogramme : Oreille gauche 2 ipsi 2 0 0 Effet on off 10 10 -2 -400 -300 -200 -100 0 100 200 -2 -400 -300 -200 -100 0 100 200 250 500 1000 2000 4000 8000 Weber 8 8 Audiogramme Vocal 100 % 6 6 f m F Score de reconnaissance vocale 4 4 50 % 2 2 0 0 0 % 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 105 110 -400 -300 -200 -100 0 100 200 -400 -300 -200 -100 0 100 200 Niveau d'audition dB HV