By Michael E. Glasscock, Aina Julianna Gulya M.D.
Glasscock-Shambaugh surgical procedure of the Ear has lengthy been the reference of selection for otolaryngologists and neurosurgeons. during this 5th variation of the vintage textual content, the authors have maintained its authoritative and sensible personality whereas improving its relevance by way of updating its contents to mirror the evolution of otology. Glasscock-Shambaugh surgical procedure of the Ear, 5/e solutions the necessity for a readable source to the surgical administration of ailments and problems of the temporal bone, lateral cranium base, and similar buildings. It comprises improved insurance of particular subject matters similar to cochlear implants. This publication will end up to be an excellent reference for the working towards clinician and the right examine consultant for the resident/fellow.
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4. Focus the microscope on the crosshatch target with the magnification changer at maximum. The fine focus knobs are to be used for this setting. When this setting is achieved, lightly tighten all tension knobs, making sure that the microscope is stable and has not moved or changed focus. 5. Being careful not to change focus, revolve the magnification changer to the lowest magnification. 6. While closing one eye, adjust the other eyepiece for the best image possible. When this has been accomplished for both eyes, tighten the diopter locks and make a note of the right and left eye settings for future use.
Optional items include exchangeable objective lenses with differing focal lengths or a variable focal length system and beam splitters to allow for the placement of teaching heads or cameras (Figure A–11). The eyepieces contribute to the total magnification and compensate for operator visual acuity differences. It is very important that the eyepieces be correctly set and then locked, ensuring that the microscope is par focal. The major cause of eye fatigue, loss of convergence, and excessive refocusing is improper eyepiece settings.
A thorough familiarity with these variables must be gained through practice in the temporal bone laboratory. A large bur contacts a greater surface area than a smaller bur. Thus, larger burs are generally more efficient in bone removal. Furthermore, the large surface area distributes the pressure of the bur tip, thus reducing the likelihood of the bur penetrating and damaging underlying structures. Hence, not only are larger burs more efficient, they are also “safer” and, accordingly, should be used whenever practical.