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Otology, Neurotology, and Lateral Skull Base Surgery

Operating in the Ear and Skull Base

Medtronic offers powered and manual ENT instruments for performing a full range of otology, neurotology, and skull base surgery procedures, from tympanostomy tube placement to advanced skull base procedures using surgical navigation.

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Summary

Otology, Neurotology, and Lateral Skull Base Surgery

These specialties manage diseases and disorders of hearing, balance, cranial nerves, and the skull base. It's important to have precision tools that can maneuver tight spaces, provide maximum visibility, and help you avoid injuring critical structures. Medtronic offers a broad portfolio of ENT products designed specifically for otology, neurotology, and lateral skull base procedures, from tympanostomy tube placement to advanced skull base surgery requiring a multidisciplinary approach and surgical navigation.

Our tools for both adult and pediatric patients provide excellent visualization and access for many specific surgeries, including:

  • Cholesteatoma
  • Otosclerosis
  • Ossicular chain reconstruction
  • Cochlear implants
  • Otitis media
  • Acoustic neuroma and other cranial base tumors
  • Adenoid disorders
  • Tympanic membrane perforations
  • Benign paroxysmal positional vertigo (BPPV)
  • Facial nerve disorders, such as Bell's palsy and neuroma

Powered Instruments and Products

Integrated Power Console and Handpieces

Our Powered ENT Instruments include the multispecialty Integrated Power Console, Straightshot® M4 Microdebrider, Indigo Otologic Drill, Visao Otologic Drill, and Midas Rex® Legend Stylus Surgical Drills. These innovative tools can facilitate more precise tissue removal, visibility, and surgical access during otology, neurotology, and lateral skull base procedures.

We also offer the most comprehensive selection of application-specific blades and burs, including:

  • Patented application-specific, high-speed curved burs that enable visibility and access during complex skull base procedures, with an outer non-rotating tube design
  • Stim Bur Guard that provides advance warning of proximity to the facial nerve during otologic surgery*
  • Anterior Skull Base Burs that comprise the most comprehensive bur selection for transnasal endoscopic surgery, enabling rapid bone and tumor removal with integrated suction-irrigation to help maximize visibility in these challenging skull base procedures
  • Automated EM Tracking Blades that are the first and only factory-calibrated blades for navigation. You can use them during anterior skull base surgery with our Fusion® ENT Navigation System
  • Adenoidectomy blades that offer a lower recurrence rate of otitis media compared to other techniques1 and better access to the choana in children more than 6 years old

Fusion ENT Navigation System

Our Fusion ENT Navigation System is an electromagnetic image-guided surgery system that offers reliable accuracy, ease of use, and expandability. Image-guided surgery with the Fusion system can help you navigate each patient's unique anatomy for safer, more thorough otology, neurotology, and lateral skull base procedures when operating near structures such as the brain, orbit, or carotid artery. The Fusion system allows customization for each surgeon, including procedure-specific pathways for lateral or anterior skull base, as well as surgeon-specific room setup.

NIM Nerve Monitoring Systems

The facial nerve and other cranial nerves are often at risk during otologic and skull base surgery. Our intraoperative NIM® Nerve Monitoring Systems enable surgeons to identify and confirm motor nerve function and monitor major motor nerves during otology, neurotology, and skull base surgeries, as well as other procedures. The NIM Systems may provide visual and audible warnings if there is a change in nerve function, helping reduce the risk of nerve damage during surgery. With the NIM-Neuro® system, surgeons can monitor up to 8 channels of nerve-muscle combinations during complex and delicate surgeries, such as glomus or acoustic tumor removals. A convenient microscope overlay feature imports the NIM-Neuro 3.0 signal through select high-end microscopes as the surgeon operates for easy access to information.

Manual Instruments and Products

Middle Ear Prostheses

For otologic health and hearing restoration, our middle ear prostheses are available in multiple combinations of biocompatible materials, shapes, and sizes for many different anatomies and conditions. See our online ENT Product Catalog for complete information.

Tympanostomy Tubes

We offer a vast selection of tympanostomy tubes to suit a variety of otologic patients and surgeon preferences. Our innovative Activent® and Microgel® tubes help inhibit bacterial growth or adherence.2-5

Activent Antimicrobial Ventilation Tubes

Activent tubes have a proven bacteriocidal/bacteriostatic effect, inhibiting the growth of bacteria that can contribute to secondary infections and postoperative otorrhea.2 Clinical data show a significant reduction in the incidence of postoperative otorrhea in ears implanted with Activent tubes compared with conventional tubes.2,3 And in vitro tests show a clear zone of bacterial inhibition around the Activent tube.4 Activent antimicrobial ventilation tubes are available in a variety of styles for your otologic patients.

Microgel Surface-Enhanced Silicone Vent Tubes

Microgel tubes have a patented hydrogel coating that increases the surface energy of silicone, reducing the attachment of microbial pathogens.5 In fact, Microgel surface enhancement reduces the occurrence of bacterial adherence by more than 90%.

Additional Products

For more otology, neurotology, and lateral skull base surgery products, see our online ENT Product Catalog.


* Nerve monitoring capability provided by our NIM-Response® or NIM-Neuro® Nerve Monitoring Systems, models 2.0 and later. Must be used with IPC® System and Visao® High-Speed Otologic Drill.


References

1

April M, Ward R, Bent J. Power-Assisted Adenoidectomy in the Treatment of Chronic Otitis Media with Effusion. Poster Presentation at: American Society of Pediatric Otolaryngology, May 4, 2003, Nashville, TN.

2

Chole RA, Hubbell RN. Antimicrobial activity of silastic tympanostomy tubes impregnated with silver oxide: a double-blind randomized multicenter trial. Arch Otolarnygol Head Neck Surg 1995; 121: 562-565.

3

Gourin CG, Hubbell RN. Otorrhea after insertion of silver oxide-impregnated silastic tympanostomy tubes. Arch Otolarnygol Head Neck Surg 1999; 125: 446-450.

4

Independent laboratory results on file with Medtronic ENT.

5

Dunkirk SG, Gregg ST, Duran LW, Monfils JD, Haapala JE, Marcy JA, Clapper DL, Amos RA, Guire PE. Photochemical coatings for the prevention of bacterial colonization. J Biomater Appl 1991; 6:131-156.