Reconstructive surgery of the middle ear bones can be performed in a variety of ways dependent upon the anatomy and clinical circumstances.  In some instances it can be performed at the primary operation and other times it is best to delay the reconstruction as a second stage, particularly in cases of intact canal wall cholesteatoma when a 'second look” procedure is planned to ensure the lack of recurrence.  The two videos below demonstrate both situations and also utilize di

While most patients with Meniere’s Disease in our practice benefit from non-invasive therapies including dietary changes and anti inflammatory therapies, there are a number of those who are not adequately controlled by these conservative measures.  When this is the case, we offer a variety of surgical treatment options which have a high rate of success in eliminating the major disabling symptoms of Meniere’s Disease and offer long term benefits.

A Cranial Base Surgeon is a member of a multidisciplinary team which includes specialists in the field of neurotology, neurosurgery, otolaryngology-head & neck surgery,  radiation oncology, neuro-oncology & interventional neuroradiology.   Patients with complex tumors and disease will often be operated and cared for by a number of specialists simultaneously, each with their own highly specialized contributions and roles.  Cranial Base Surgery is also often referred to as Skul

Clival Chordoma is a locally agressive tumor that requires the best possible resection from the outset.  Our center has significant experience in this pathology.  We are able to provide a variety of approaches including, endoscopic, transoral, as well as complex facial translocations when necessary to ensure the best and most complete resection of the lesion depending upon the extent and location of the tumor.  The video below is an example of the most complex scenario requir

Below is a video demonstration of an intact canal wall first stage resection of a cholesteatoma. Due to the large size of this file, it may best be viewed from a computer rather than mobile phone.   For the second stage technique, please refer to the section on ossiculoplasty .

Carotid Body Tumors are a form of paraganglioma similar to glomus tumors (glomus jugulare). They arise form the chemoreceptors of the carotid artery in the neck.  A comprehensive team approach is required involving interventional neurovascular embolization and close collaboration with our vascular surgery colleagues to safely and completely remove these tumors.

This video by Prof. Dr. Andrew J. Fishman (@AFMedico) demonstrates a hearing-preservation surgery for acoustic neuroma (vestibular schwannoma) using the middle fossa approach. The presentation details key steps in tumor exposure, facial and cochlear nerve protection, and microsurgical dissection techniques that maximize the chance of hearing preservation. Intended for patients exploring surgical options and surgeons refining skull-base skills, this case illustrates precision,

This educational video by Prof. Dr. Andrew J. Fishman (@AFMedico) demonstrates the translabyrinthine approach for removal of an acoustic neuroma (vestibular schwannoma). It includes detailed surgical footage and a patient testimonial describing recovery and the relief of vertigo following surgery. Created for both patients and surgeons, the presentation highlights surgical anatomy, safety strategies, and outcomes in modern skull base surgery. #AcousticNeuroma   #Translabyrint

Below is a video demonstration of an intact canal wall first stage resection of a cholesteatoma. Due to the large size of this file, it may best be viewed from a computer rather than mobile phone.   For the second stage technique, please refer to the section on ossiculoplasty .

Publication: Fishman AJ , The Expanded Transtemporal Approach for Large CPA Lesions in Master Techniques in Otology Neurotology Roland JT [Ed.] Wolters Kluwer 2019. INTRODUCTION The expanded transtemporal approach is intended to address large cerebellopontine angle (CPA) lesions. It is a non–hearing preservation approach, indicated for surgical treatment of tumors in which total or near-total surgical extirpation is the primary objective. This operation can be conceptualized

Patients with acoustic neuroma present a variety of treatment options.  Simplification of the protocol includes: serial imaging; radiosurgery; and hearing and non-hearing preservation surgical removal.  In this lecture, we will discuss the various options and present case examples as a means to better understand the choices patients have.  Ultimately, each case is individualized.  Factors that must be considered include: age, size, location, hearing levels, and degree of vest

Whether or not to surgically treat SSCD syndrome is a decision made jointly with the patient and the surgeon.  Many of the symptoms can be mild and tolerable.  There are however, individual cases where the symptoms are disabling and surgery is warranted.  Some patients can be treated with a minimally invasive technique which we have developed to minimize the manipulation of the temporal lobe of the brain.  Please watch the video below.  Others require a minimal cranial openin

Surgical Options for Meniere’s Disease While most patients with Meniere’s Disease in our practice benefit from non-invasive therapies including dietary changes and anti inflammatory therapies, there are a number of those who are not adequately controlled by these conservative measures.  When this is the case, we offer a variety of surgical treatment options which have a high rate of success in eliminating the major disabling symptoms of Meniere’s Disease and offer long term b

Only a few centers nationally offer middle fossa decompression for Bell’s Palsy.  The procedure requires that the surgical team has a significant experience with the procedure. Patients are carefully selected according to strict criteria and good health.  The criteria are based on ENOG which is performed by our partners in neurology and strict adherence to a recognized protocol.  While the majority of patients with Bell’s Palsy taken as a whole do recover well, there are a su