Chapter 29 - Anesthesia for otologic and neurotologic surgery

Summary

This chapter focuses on the fundamental principles and details of anesthesia management of adult patients presenting for selected, most common otologic and neurotologic surgical procedures, such as middle ear surgery, skull base surgery, resection of acoustic neuroma, and cochlear implantation. Most otologic surgical procedures are performed via either a transcanal approach (through the natural meatus of the external ear), a retroauricular incision, or a combination of the two. General surgical and anesthesia considerations for neurotologic procedures have been discussed. Anesthetic evaluation and management of uncomplicated neurotologic procedures aimed at restored hearing, such as bone-anchored hearing aids (BAHA) or cochlear implantation, generally follows the same path as anesthesia for otologic surgery. The anesthesiologist should be very familiar with the nature of the pathological process, understand the critical parts of the surgical procedure, and communicate closely with the surgeon during the perioperative period.