A complex case of Dr. José Carlos Casqueiro
Managing complex cases such as cholesteatoma with dehiscent facial nerve poses major challenges in Otolaryngology. In this article, we will explore a surgical case led by Dr. José Carlos Casqueiro, a renowned otolaryngologist, where he performed the resection of an invasive cholesteatoma in a 12-year-old girl. This procedure, recorded on video in the app SurgSchool For surgical learning, it is a clear example of the advances in endoscopic techniques and how they can help preserve vital structures, such as the facial nerve.
The Challenge of Cholesteatoma in Pediatric Patients
Cholesteatoma is a chronic pathology of the middle ear that can cause hearing loss, recurrent infection and, in more severe cases, invasion of the bone structures of the ear. In pediatric patients, such as in the case of this 12-year-old girl, the risk is even greater due to the possibility of growth and progressive damage to key structures. In this particular case, the cholesteatoma affected hard-to-reach areas, such as the facial recess and the geniculate ganglion, presenting a dehiscence of the facial nerve.
Surgical procedure
Constant Monitoring of the Facial Nerve
Given the proximity of the cholesteatoma to the facial nerve and the risk of permanent damage, constant intraoperative monitoring of the facial nerve was used throughout the procedure. This monitoring is crucial to prevent injury and preserve patient functionality in the long term.
Endoscopic Resection of Complex Regions
The resection of the cholesteatoma was performed with advanced endoscopic techniques, allowing the surgeon to access complex areas such as the facial recess and the geniculate ganglion, both of which are difficult to access. Dr. Casqueiro He used specialized tools, such as Yamagata forceps, to ensure complete removal of the cholesteatoma, minimizing damage to surrounding structures and ensuring precise intervention.
Ossicular Reconstruction with Cartilage
Following resection of the cholesteatoma, ossicular reconstruction was performed using autologous cartilage, ensuring stability of the ossicular chain and preservation of auditory function. Correct graft placement is vital to ensure proper healing and prevent further retractions.
Access This Case and Others at SurgSchool
This case of cholesteatoma with facial nerve dehiscence is just one example of the many surgical cases that you can find in SurgSchool, the surgical training app designed for ENT Physicians and surgeons around the world. In SurgSchool, you have access to high-quality surgical videos, led by international experts such as Dr. Casqueiro, which will allow you to:
- Improve your surgical skills with challenging and real cases.
- Access to the latest surgical techniques in Otolaryngology and other specialties.
- Learning from international experts who share their knowledge and experience through our high-quality recorded surgeries.
Download SurgSchool and Improve your Surgical Training
If you are an ENT doctor looking to improve your training, download the app SurgSchool todayWith cases like this and many more, you will have access to complex surgeries and cutting-edge techniques from the comfort of your mobile device. Available on the App Store and Google Play, with basic and premium plans tailored to your training needs.
Download SurgSchool now and take your surgical training to the next level!
