Surgical anatomy of the hypotympanum

AbstractAnatomical characteristics of the hypotympanum were tested on 50 temporal bones. The hypotympanum has the shape of an irregular bony groove which is surrounded by five walls. The outer wall is formed by the tympanic part of the temporal bone. In 65 per cent of the cases the inner wall is formed by part of the petrous bone which extends under the promontory; in 25 per cent it is formed only by the lower part of the promontory; and in 10 per cent it corresponds to the juncture of the promontory and the petrous bone. The lower wall is clearly defined in 48.2 per cent of cases and corresponds to the juncture of its inner and outer walls. In 65 per cent of cases a recess of the inferior hypotympanic sinus is found on the floor of the hypotympanum. In 25.3 per cent of cases the jugular bulb protrudes into the tympanic cavity. In 73.4 per cent of cases the front wall is formed by part of the petrous bone which extends from its floor towards the tympanic opening of the protympanum, and in 26 per cent of the cases it is formed by the wall of the internal carotid artery. On the front wall, in 22.4 per cent of cases, a recess of the anterior hypotympanic sinus is found. The back wall is formed by elements of the styloid complex and in five per cent of the cases a recess or posterior hypotympanic sinus is found on it.

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Anatomical characteristics of the fossula fenestrae vestibuli

The Journal of Laryngology & Otology ◽

10.1017/s002221510010194x ◽

1987 ◽

Vol 101 (5) ◽

pp. 426-431 ◽

Cited By ~ 4

Author(s):

D. Djerić ◽

D. Savić

Keyword(s):

Surgical Intervention ◽

Anatomical Variations ◽

Medial Wall ◽

Front Wall ◽

Facial Canal ◽

Tympanic Cavity ◽

Lower Wall ◽

Back Wall ◽

Anatomical Characteristics ◽

Temporal Bones

AbstractAnatomical characteristics of the fossula fenestrae vestibuli were tested and analysed precisely on 200 samples of temporal bones. The fossula is usually ovoid and shallow but can be, exceptionally, elongated, narrow and deep. It is surrounded by four walls. In 45.5 per cent of cases the upper wall is formed only by the facial canal and in 54.5 per cent of cases a bony lamella is found beneath the facial canal; the promontory forms the lower wall; the front wall is formed by the bony lamella and part of the processus cochleariformis; the back wall is clearly defined in only 22.8 per cent of cases and is formed by the bony lamella of the medial wall of the tympanic cavity. In 13.2 per cent of cases the floor of the fossula partially covers the prominence of the facial canal and in two per cent the eminentia pyramidalis. Bony recesses in this region occur fairly frequently: sinus subfacialis in 60 per cent, sinus retrofenestralis in 77.2 per cent, and sinus subrostralis in 25 per cent of the cases. These anatomical variations can influence the result of surgical intervention.

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Infracochlear access to the petrous apex (morphometrics)

Russian Medical Inquiry ◽

10.32364/2587-6821-2021-5-7-486-491 ◽

2021 ◽

Vol 5 (7) ◽

pp. 486-491

Author(s):

I.A. Anikin ◽

◽

N.N. Khamgushkeeva ◽

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Facial Nerve ◽

Internal Carotid ◽

Jugular Bulb ◽

Petrous Apex ◽

Tunnel Length ◽

Surgical Access ◽

Surgical Tactics ◽

Temporal Bones

Aim: to study morphometrics data of the infracochlear tunnel on the cadaveric temporal bones, sufficient for its rehabilitation. Patients and Methods: the study was performed on 30 cadaveric temporal bones. The measurement was made using a measurement probe, a micrometer ruler, and a digital caliper. The following parameters were studied: the distances concerning the location of the facial nerve in relation to the infracochlear tunnel; the distances between the anatomical structures of the infracochlear tunnel in its various sections (from the internal carotid artery to the jugular vein); the length of the infracochlear tunnel (bisector drawn between the internal carotid artery and the jugular bulb to the basal whorl of the cochlea); the depth of the infracochlear tunnel (distance to the petrous apex from the basal whorl of the cochlea). A comparative analysis of the results obtained with the data of other scientific studies was conducted. Results: infracochlear access on the cadaveric temporal bones was performed in our study only on 18 cadaveric temporal bones (60% of cases). During surgical access to the petrous apex, a 2 mm cutter was used to avoid injury to adjacent vessels. Based on the obtained data, differences in the structure of the infracochlear tunnel were noted depending on the pneumatization of the petrous apex. The main parameters of the infracochlear tunnel have been determined, which can be applied in the choice of surgical tactics for the removal of pathological formation from the petrous apex. Conclusions: there are the following anatomical prerequisites for conducting infracochlear access to the petrous apex for its lavage: infracochlear tunnel width from 5 mm, infracochlear tunnel length from 5.5 mm, the distance between the mastoid part of the facial nerve to the anterior margin of the cochlea window from 4.8 mm. These parameters can be applied in the assessment of patients’ CT scans to determine the indications for infracochlear access to the petrous apex. KEYWORDS: petrous pyramid, petrous apex, infracochlear tunnel, infracochlear access, cadaveric temporal bones, morphometrics. FOR CITATION: Anikin I.A., Khamgushkeeva N.N. Infracochlear access to the petrous apex (morphometrics). Russian Medical Inquiry. 2021;5(7):486–491 (in Russ.). DOI: 10.32364/2587-6821-2021-5-7-486-491.

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Local anaesthetic surgical treatment of severe objective pulsatile tinnitus: a useful technique

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221498820 ◽

2012 ◽

Vol 94 (4) ◽

pp. e139-e140 ◽

Cited By ~ 1

Author(s):

AA Aikoye ◽

TY Tang ◽

FJ Meyer

Keyword(s):

Computed Tomography ◽

Local Anaesthetic ◽

Internal Carotid ◽

Jugular Vein ◽

Rare Condition ◽

Jugular Bulb ◽

Pulsatile Tinnitus ◽

History Of ◽

Temporal Bones ◽

Dramatic Presentation

Objective pulsatile tinnitus is a rare condition with an often dramatic presentation. We present the case of a 70-year-old woman who presented with over two years’ history of unilateral distressing objective pulsatile tinnitus. Carotid arteriography revealed a highly tortuous internal carotid artery. Computed tomography of the ipsilateral temporal bones showed a large jugular bulb. Internal jugular vein ligation under local anaesthetic yielded immediate resolution of her symptoms.

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The remnant of primary head sinus found in the case of dural arteriovenous fistula: A case report

Interventional Neuroradiology ◽

10.1177/1591019916641903 ◽

2016 ◽

Vol 22 (4) ◽

pp. 452-456 ◽

Cited By ~ 1

Author(s):

Katsuhiro Mizutani ◽

Takenori Akiyama ◽

Kazunari Yoshida

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Rare Condition ◽

Venous Drainage ◽

Petrous Bone ◽

Jugular Bulb ◽

Cone Beam ◽

Middle Fossa ◽

Rotational Angiography ◽

Anatomic Information

In the embryo, the primary head sinus (PHS) is the first venous drainage channel in the craniocervical region. During embryonic development, this channel regresses and usually disappears completely; accordingly, a remnant of the PHS is an extremely rare condition and has been described in only a few previous studies. Here, we report a case of remnant of the PHS with a dural arteriovenous fistula (dAVF) in an adult. The remnant of the PHS had penetrated the petrous bone to run from the middle fossa to the jugular bulb and served as a drain for the middle fossa dAVF. We used digital subtraction angiography and reconstructed cone-beam computed tomography in 3D rotational angiography to obtain detailed anatomic information about the remnant PHS and additionally scrutinised and discussed its features.

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Maturation of the anterior petrous apex: surgical relevance for performance of the middle fossa transpetrosal approach in pediatric patients

Journal of Neurosurgery ◽

10.3171/2021.3.jns202648 ◽

2021 ◽

pp. 1-7

Author(s):

Robert C. Rennert ◽

Michael G. Brandel ◽

Jeffrey A. Steinberg ◽

David D. Gonda ◽

Rick A. Friedman ◽

...

Keyword(s):

Pediatric Patients ◽

Internal Carotid ◽

Age Groups ◽

Internal Auditory Canal ◽

Petrous Bone ◽

Growth Patterns ◽

Ct Scans ◽

Petrous Apex ◽

Middle Fossa ◽

Region Growth

OBJECTIVE The middle fossa transpetrosal approach to the petroclival and posterior cavernous sinus regions includes removal of the anterior petrous apex (APA), an area well studied in adults but not in children. To this end, the authors performed a morphometric analysis of the APA region during pediatric maturation. METHODS Measurements of the distance from the clivus to the internal auditory canal (IAC; C-IAC), the distance of the petrous segment of the internal carotid artery (petrous carotid; PC) to the mesial petrous bone (MPB; PC-MPB), the distance of the PC to the mesial petrous apex (MPA; PC-MPA), and the IAC depth from the middle fossa floor (IAC-D) were made on thin-cut CT scans from 60 patients (distributed across ages 0–3, 4–7, 8–11, 12–15, 16–18, and > 18 years). The APA volume was calculated as a cylinder using C-IAC (length) and PC-MPB (diameter). APA pneumatization was noted. Data were analyzed by laterality, sex, and age. RESULTS APA parameters did not differ by laterality or sex. APA pneumatization was seen on 20 of 60 scans (33.3%) in patients ≥ 4 years. The majority of the APA region growth occurred by ages 8–11 years, with PC-MPA and PC-MPB increasing 15.9% (from 9.4 to 10.9 mm, p = 0.08) and 23.5% (from 8.9 to 11.0 mm, p < 0.01) between ages 0–3 and 8–11 years, and C-IAC increasing 20.7% (from 13.0 to 15.7 mm, p < 0.01) between ages 0–3 and 4–7 years. APA volume increased 79.6% from ages 0–3 to 8–11 years (from 834.3 to 1499.2 mm3, p < 0.01). None of these parameters displayed further significant growth. Finally, IAC-D increased 51.1% (from 4.3 to 6.5 mm, p < 0.01) between ages 0–3 and adult, without significant differences between successive age groups. CONCLUSIONS APA development is largely complete by the ages of 8–11 years. Knowledge of APA growth patterns may aid approach selection and APA removal in pediatric patients.

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Polytomography and Congenital Anomalies of the Ear

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948209100503 ◽

1982 ◽

Vol 91 (5) ◽

pp. 480-484 ◽

Cited By ~ 2

Author(s):

J. William Wright ◽

George Hicks

Keyword(s):

Temporal Bone ◽

Congenital Anomalies ◽

Internal Auditory Canal ◽

Semicircular Canals ◽

Conventional Radiography ◽

Jugular Bulb ◽

External Ear ◽

Tympanic Cavity ◽

Axial Tomography ◽

Computerized Axial Tomography

Conventional radiography and even high resolution computerized axial tomography leave much to be desired in demonstrating the minutiae of the anatomy of the temporal bone. Multidirectional tomography remains the examination of choice radiographically in cases of congenital anomalies of the temporal bone. Details of the inner, middle and even external ear in the presence of atresia are more clearly delineated by this method than any other to date. Such information is of inestimable value to the surgeon in the diagnosis and surgical correction of anomalies of the temporal bone. Important features of the vestibule, semicircular canals, cochlea, facial nerve, internal auditory canal, temporomandibular joint, pneumatization of the temporal bone, tegmen, tympanic cavity, ossicles, oval and round windows, jugular bulb and carotid artery and the external ear canal are discerned most clearly by multidirectional tomography.

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Vestibular schwannoma extending into the tympanic cavity and jugular fossa by invasion of the petrous bone

British Journal of Neurosurgery ◽

10.1080/02688697.2019.1588226 ◽

2019 ◽

pp. 1-3

Author(s):

Hideaki Matsumura ◽

Masahide Matsuda ◽

Keiji Tabuchi ◽

Tetsuya Yamamoto ◽

Eiichi Ishikawa ◽

...

Keyword(s):

Vestibular Schwannoma ◽

Petrous Bone ◽

Tympanic Cavity ◽

Jugular Fossa

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Surgical anatomy of the internal carotid plexus branches to the abducens nerve in the cavernous sinus

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2020.105690 ◽

2020 ◽

Vol 191 ◽

pp. 105690

Author(s):

Joe Iwanaga ◽

Mahindra Kumar Anand ◽

Amarilis Camacho ◽

Felix Rodriguez ◽

Caroline Watson ◽

...

Keyword(s):

Cavernous Sinus ◽

Internal Carotid ◽

Abducens Nerve ◽

Surgical Anatomy

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Study on Stressed Characteristic of Gridding Concrete Retaining Wall Used in Excavation of Soft-Soil Foundation Pit

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.243-249.2266 ◽

2011 ◽

Vol 243-249 ◽

pp. 2266-2270

Author(s):

Guang Zhu Zhou ◽

Xu Wei ◽

Chen Yu

Keyword(s):

Retaining Wall ◽

Soft Soil ◽

Side Wall ◽

Building Envelope ◽

Front Wall ◽

Soil Pressure ◽

Back Wall ◽

Foundation Pit ◽

Partition Wall ◽

Finite Element Software

As a new type of building envelope, Gcrw is mainly used for excavation of foundation pit. It can stand by itself without the help of bracing, especially in soft soil area. Its stressed characteristic hasn’t been known yet. By using advanced big finite element software Abaqus/Cae, a simulation was made on model of Gcrw under soil pressure when a foundation pit is dug, while the whole excavation is divided into three continuous independent excavation stages. The result shows that Gcrw is a rather good building envelope, Gcrw and soil in the gridding form an integral earth-retaining structure and keep balance under soil pressure before or behind the structure, and have little displacement in horizontal direction. It is like a gravity-type retaining wall in its entirety, but takes on an elastic characteristic. The soil pressure presents a linear change, but its value is less than the theoretical value of calculation. The front wall of Gcrw, like a sheet, is the main flexural construction element, which is subjected to the pressure from side wall of foundation pit and produce curve deformation. The back wall of Gcrw has little displacement and almost is built in the clay. The partition wall endures the effect of the tensile force, its horizontal deformation increases with the build-in depth’s increasing. The back wall and the partition wall play a very important role in dragging back the front wall, the role of them is similar to a pair of anchor tie. The soil in the gridding not only provides soil pressure, but also can fix the back wall, so it is seen as a part of Gcrw and in favor of the Gcrw’s anti-overturn.

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