What is Otoneurosurgery?
Otoneurosurgery is the branch of Otoneurology that is dedicated to surgically treat all the pathologies that are included in it. Thus, it will treat diseases affecting the inner ear and a number of nerves that run through the ear or its vicinity (facial, auditory, vestibular and lower cranial nerves, hypoglossal, vagus and spinal). Thus, the surgery of Acoustic Neurinoma, posterior fossa surgery and surgery of the lateral region of the skull base, among others, are included. It is the specialist in Otorhinolaryngology who will perform the interventions, with microscopic practice and the necessary precision to act in narrow fields.
Why is it performed?
Otoneurosurgery is used for the early diagnosis of peripheral or central lesions, or pathology of the lateral skull base, as well as its treatment. The diagnosis of acoustic neuroma is based on a high index of suspicion in the presence of deterioration of the auditory and vestibular functions. It will be the otolaryngologist who, by means of the different techniques of otoneurosurgery and their approaches, will know the auditory and vestibular pathways, as well as the preservation of the organs and the rehabilitation of hearing with cochlear implants or trunk implants, and of balance with dynamic posturography. Likewise, neurosurgery also includes knowledge of the facial nerve and the ability to manage this nerve and rehabilitate its sequelae.
What does it consist of?
Otoneurosurgery uses different types of approaches to be able to correctly access the patient’s ailment. Thus, there are approaches called presigmoid as the retrolabyrinthine, translabyrinthine, transcochlear or transosseous, as well as orifices through the middle cranial fossa. All of them are a common part of the otolaryngologist’s work. Likewise, infratemporal approaches and the combination of many of them allow access to lesions of more complex location. Traditionally neurosurgical approaches, such as the retrosigmoid or the extreme lateral approach, are also part of otorhinolaryngology. The specialist will normally apply local anesthesia to be able to make the necessary incisions and interventions on the patient, and will recommend the best type of approach in each case.
Preparation for Otoneurosurgery
Before the otoneuro surgery the specialist in Otolaryngology will study that the patient has no ear infection. To do this, he/she will perform several tests, including an ear examination and hearing tests. In other cases a computerized tomography of the head will also be necessary. It is also important for the patient to consult the physician about which medications he/she may or may not take. Thus, it may be necessary to stop taking certain medications (aspirin or anti-inflammatory drugs, or anticoagulants) one week before the operation.
Care after the operation
The patient should follow a series of tips to ensure proper recovery after surgery. The ENT specialist should advise you but you should not suffer any blows to the ear, you should avoid getting water in it, as well as flying in an airplane, swimming or diving, or any excess stress.