Home Temporal Bone Dissection: Anatomic Approaches to Ear Surgery

1980 ◽  
Vol 88 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Jay B. Farrior
Keyword(s):  
Temporal Bone ◽  
High Speed ◽  
Internal Auditory Canal ◽  
Surgical Approaches ◽  
Ear Surgery ◽  
Laboratory Facilities ◽  
Temporal Bone Anatomy ◽  
Temporal Bones ◽  
At Home

The anatomy of the temporal bone can only be mastered by repeated surgical and anatomic dissections. For the otolaryngologist who does not have access to laboratory facilities, a technique for dissecting temporal bones at home using readily available and inexpensive equipment is described. The basic home dissecting kit consists of dry temporal bones, a high-speed hobby drill, dental burrs, loupes, and paints. The preparation of temporal bones for dissection and approaches to anatomic, transmastoid, transcanal, and neuro-otologic dissections are presented. The relative benefits of home dissection in learning temporal bone anatomy and developing new surgical approaches, such as a transcanal-transcochlear approach to the internal auditory canal, are discussed.

S237 – Computerized Tomography in the Prediction of CSF Gusher

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P154-P155
Author(s):  
Vanessa S Rothholtz ◽  
Mahmood F Mafee ◽  
Nancy M Young
Keyword(s):  
Cochlear Implant ◽  
Temporal Bone ◽  
Computerized Tomography ◽  
Cochlear Implantation ◽  
Statistical Significance ◽  
Internal Auditory Canal ◽  
Implant Surgery ◽  
Tegmen Tympani ◽  
Cochlear Implant Surgery ◽  
Temporal Bone Anatomy

Objectives 1) Identify anatomic variations of the temporal bone in children with and without cochlear malformations who experienced an intra-operative cerebrospinal fluid (CSF) gusher at the time of cochlear implantation. 2) Compare the anatomic findings in the current study to those described in prior studies. Methods A retrospective case-controlled chart review was performed on patients undergoing cochlear implant surgery. Computerized tomography images were analyzed in a single-blind fashion for characteristics and measurements of both the right and left cochlea, internal auditory canal, cochlear aperture, facial nerve canal, vestibular aqueduct, cochlear aqueduct, oval window, round window, vestibule, mastoid, tegmen tympani and semi-circular canals. After verifying equal variances, data was statistically evaluated utilizing the paired 2-tailed t test with criterion for statistical significance set at p < 0.05. Results The average age at implantation for this series of children was 4 years old. 70% of patients had cochlear malformations. 25% of patients had an abnormal internal auditory canal (IAC) and 30% had a widened cochlear aperture. Most patients with an abnormal IAC had an abnormal cochlear aperture; however, some patients with a normal IAC also had an abnormal cochlear aperture. Correlations between the temporal bone anatomy and the incidence of CSF gushers will be discussed. Conclusions Specific characteristics of the temporal bone anatomy may lead to an increased incidence of CSF gusher in cochlear implant surgery. Computerized tomography of the temporal bone can assist in the surgeon in evaluation and planning for cochlear implantation.

Anatomic Considerations of the Medial Cuts in the Subtotal Temporal Bone Resection

1982 ◽  
Vol 90 (5) ◽  
pp. 641-645 ◽  
Author(s):  
J. Gail Neely ◽  
Michael Forrester
Keyword(s):  
Temporal Bone ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Lateral Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bone Resection ◽  
En Bloc ◽  
Temporal Bone Resection ◽  
Temporal Bones

Eighteen temporal bones, 20 sets of polytomograms, and two sets of histologically sectioned temporal bones were studied and the literature was reviewed in order to describe the evolution and anatomic detail of the medial limits of the subtotal temporal bone resection used when malignant neoplasia has invaded the middle ear. An en bloc resection requires incisions medial to the pneumatized spaces involved. The anatomy of the lines of resection through the glenoid fossa, medial to the lateral wall of the carotid canal, through the cochlea, internal auditory canal, and jugular bulb, and just lateral to cranial nerves IX, X, and XI was described in detail. Regardless of the techniques employed, or the feasibility of the task, the concept of en bloc resection must conform to the anatomy of the region.

Feasibility of ovine and synthetic temporal bone models for simulation training in endoscopic ear surgery

2019 ◽  
Vol 133 (11) ◽  
pp. 966-973 ◽  
Author(s):  
S Okhovat ◽  
T D Milner ◽  
A Iyer
Keyword(s):  
Temporal Bone ◽  
Content Validity ◽  
Interquartile Range ◽  
Face Validity ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Specific Content ◽  
The Face ◽  
Temporal Bones ◽  
Endoscopic Tympanoplasty

AbstractObjectiveComparing the feasibility of ovine and synthetic temporal bones for simulating endoscopic ear surgery against the ‘gold standard’ of human cadaveric tissue.MethodsA total of 10 candidates (5 trainees and 5 experts) performed endoscopic tympanoplasty on 3 models: Pettigrew temporal bones, ovine temporal bones and cadaveric temporal bones. Candidates completed a questionnaire assessing the face validity, global content validity and task-specific content validity of each model.ResultsRegarding ovine temporal bone validity, the median values were 4 (interquartile range = 4–4) for face validity, 4 (interquartile range = 4–4) for global content validity and 4 (interquartile range = 4–4) for task-specific content validity. For the Pettigrew temporal bone, the median values were 3.5 (interquartile range = 2.25–4) for face validity, 3 (interquartile range = 2.75–3) for global content validity and 3 (interquartile range = 2.5–3) for task-specific content validity. The ovine temporal bone was considered significantly superior to the Pettigrew temporal bone for the majority of validity categories assessed.ConclusionTympanoplasty is feasible in both the ovine temporal bone and the Pettigrew temporal bone. However, the ovine model was a significantly more realistic simulation tool.

scholarly journals A Study of Middle Cranial Fossa Anatomy and Anatomic Variations

2007 ◽  
Vol 86 (8) ◽  
pp. 474-481 ◽  
Author(s):  
Hamid R. Djalilian ◽  
Kunal H. Thakkar ◽  
Sanaz Hamidi ◽  
Aaron G. Benson ◽  
Mahmood F. Mafee
Keyword(s):  
Temporal Bone ◽  
Internal Auditory Canal ◽  
Middle Cranial Fossa ◽  
Anterior Wall ◽  
High Resolution Computed Tomography ◽  
Anatomic Landmarks ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa ◽  
Picture Archiving And Communication ◽  
Temporal Bones

We conducted a study to establish standardized measurements of the common anatomic landmarks used during surgery via the middle cranial fossa approach. Results were based on high-resolution computed tomography (CT) images of 98 temporal bones in 54 consecutively presenting patients. Measurements were obtained with the assistance of the standard PACS (picture archiving and communication system) software. We found that the superior semicircular canal (SSC) dome was not the highest point on the temporal bone (i.e., the arcuate eminence) in 78 of the temporal bone images (79.6%). Pneumatization above the SSC and above the internal auditory canal (IAC) was found in 27 (27.6%) and 39 (39.8%) temporal bone images, respectively. The anterior wall of the external auditory canal was always anterior to the anterior wall of the IAC. The mean angles between the SSC and the posterior and anterior walls of the IAC were 42.3° and 60.8°, respectively. We also measured other distances, and we compared our findings with those published by others. We hope that the results of our study will help surgeons safely and rapidly locate anatomic landmarks when performing surgery via the middle cranial fossa approach.

Experimental Viral Infections of the Inner Ear II. Simian Virus 40 Induced Tumors of the Temporal Bone

1979 ◽  
Vol 88 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Larry E. Davis ◽  
George T. Nager ◽  
Richard T. Johnson
Keyword(s):  
Inner Ear ◽  
Choroid Plexus ◽  
Temporal Bone ◽  
Viral Infections ◽  
Choroid Plexus Papilloma ◽  
Internal Auditory Canal ◽  
Simian Virus 40 ◽  
Simian Virus ◽  
Cochlear Aqueduct ◽  
Temporal Bones

Pathological and virological studies were performed on temporal bones of 23 hamsters which developed tumors subsequent to neonatal inoculation of simian virus 40 (SV40). Four to five months after viral inoculation, 22 hamsters developed undifferentiated sarcomas in the subcutaneous space adjacent to the temporal bone. Nine tumors invaded the temporal bone, occasionally extending to the subarachnoid space but not to the inner ear. Choroid plexus papillomas developed in four animals, with one tumor demonstrating invasion of the cochlear aqueduct, internal auditory canal, and cochlear modiolus. Cells grown from a sarcoma and a choroid plexus papilloma contained tumor antigen and established that the tumors were SV40 virus induced.

Metastatic tumours of the temporal bone

1985 ◽  
Vol 99 (9) ◽  
pp. 839-846 ◽  
Author(s):  
A. Belal
Keyword(s):  
Bone Metastasis ◽  
Thyroid Gland ◽  
Temporal Bone ◽  
Microscopic Examination ◽  
Internal Auditory Canal ◽  
Petrous Apex ◽  
Mastoid Bone ◽  
Tegmen Tympani ◽  
Temporal Bones

AbstractMetastatic tumours of the temporal bone seem to be more common than is recognized. Most of these tumours are microscopic and asymptomatic in nature. Microscopic examination of 22 temporal bones belonging to 13 cases of metastatic tumours is reported. The commonest site of involvement in the temporal bone was the petrous apex followed by the tegmen tympani, mastoid bone and internal auditory canal. Primary tumours were most commonly located in the breast. Other sites of primary tumours included the thyroid gland, brain, lungs, prostate and blood (leukaemia). Two cases had undetermined sites of origin. Full neurotologic evaluation is indicated in every case suspected of having a temporal bone metastasis. All three modalities (of surgery, radiotherapy and chemotherapy) are used in combination for the treatment of these tumours.

Investigation of Temporal Bone Anatomy by Plastic Moulding and Cryomicrotomy

1986 ◽  
Vol 27 (4) ◽  
pp. 389-394 ◽  
Author(s):  
H. Wilbrand ◽  
W. Rauschning
Keyword(s):  
Temporal Bone ◽  
Polyester Resin ◽  
Plastic Material ◽  
Three Dimensional ◽  
Accurate Information ◽  
Radiographic Images ◽  
Cochlear Aqueduct ◽  
Temporal Bone Anatomy ◽  
Temporal Bones ◽  
Bone Structures

To increase our understanding of the complex topographic relations between temporal bone structures and to facilitate the interpretation of their radiographic images, two techniques were developed. 1) Plastic moulding of temporal bone specimens using polyester resin and silicone rubber substances providing detailed information and a three-dimensional survey of the structures. Carefully macerated temporal bone specimens are filled with plastic material under vacuum and the bone is then dissolved. The preparations, freed from irrelevant structures and embellished, allow metric evaluation of the different structures and their topographic relations. 2) Automatic serial cryomicrotomy of fresh, deep-frozen temporal bones, using a commercial sledge-cryomicrotome. Photography of the cut surfaces of the specimen, usually at distances of 0.25 to 0.50 mm, allows natural-colour reproduction of minute detail, e.g. the melanin cell area in the cochlea, the smallest vessels on the ossicular surfaces, and the origin of the cochlear aqueduct at the basal turn of the cochlea. By correlating the photographs with images from the corresponding tomographic planes accurate information is obtained for interpretation of the radiographic images. A combination of the two techniques facilitates a detailed study and is a valuable aid in the teaching of temporal bone anatomy.

Transcranial translabyrinthine approach to vestibular schwannomas

1993 ◽  
Vol 107 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Joseph G. Feghali ◽  
Allen B. Kantrowitz
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Semicircular Canal ◽  
Internal Auditory Canal ◽  
Endolymphatic Sac ◽  
Vestibular Schwannomas ◽  
Translabyrinthine Approach ◽  
Vestibular Aqueduct ◽  
Temporal Bones ◽  
Suboccipital Approach

Surgeons who utilize the suboccipital approach for the removal of large vestibular schwannomas, can perform a planned labyrinthectomy from within the intracranial cavity via the suboccipital exposure. This transcranial translabyrinthine approach provides one of the major advantages of the conventional transmastoid translabyrinthine approach, namely, unambiguous identification of the facial nerve as it exits the internal auditory canal, without the need for complete mastoidectomy and labyrinthectomy. The labyrinthectomy is best performed prior to the complete exposure of the internal auditory canal. The approach requires the surgeon to identify the endolymphatic sac intracranially, then drill the temporal bone and follow the vestibular aqueduct to the utricle. The lateral and superior semicircular canal ampullae, the superior vestibular nerve, Bill's bar, and the facial nerve at the lateral end of the internal auditory canal can then be identified. After testing on multiple cadaver temporal bones, this approach was used in patients with large tumours that extended far laterally in the internal auditory canal. The steps in the technique are described in detail.

Surgical Anatomy of the Temporal Bone in the Chinchilla

1978 ◽  
Vol 87 (6) ◽  
pp. 875-882 ◽  
Author(s):  
George G. Browning ◽  
Mark S. Granich
Keyword(s):  
Temporal Bone ◽  
Ossicular Chain ◽  
Surgical Anatomy ◽  
The Other ◽  
Surgical Approaches ◽  
It Projects ◽  
External Canal ◽  
Temporal Bones ◽  
Bone Structures ◽  
The Brain

The chinchilla is of value in otological research for many reasons, including the surgical accessibility of the majority of structures within its temporal bone. This paper describes the anatomy of the chinchilla's temporal bone, and four surgical approaches to the labyrinth and ossicular chain, three through the bulla and the other via the external canal. No one approach reveals all the temporal bone structures, and each route is therefore more suited to some surgical procedures than others. The cochlea is particularly accessible for microsurgical procedures because it projects into the labyrinthine part of the bulla and because its bony capsule is thin. Surgery in the posterior cranial fossae is both hazardous and difficult; the hazard is bleeding from the venous sinuses which run within the occipital and temporal bones, and the difficulty is the limited access due to the intervening cerebellum and the closeness of the brain stem.

scholarly journals Risk of Posterior Semicircular Canal Trauma when using a Retrosigmoid approach for Acoustic Neuroma Surgery and role of Endoscopy: An Imaging Study

2018 ◽  
Vol 97 (1-2) ◽  
pp. 24-30 ◽  
Author(s):  
Ali Kouhi ◽  
Varasteh Vakili Zarch ◽  
Ali Pouyan
Keyword(s):  
Temporal Bone ◽  
Semicircular Canal ◽  
Internal Auditory Canal ◽  
Imaging Study ◽  
Hearing Preservation ◽  
Neoplastic Disease ◽  
Posterior Semicircular Canal ◽  
Temporal Bone Ct ◽  
Temporal Bones

The rate of hearing preservation after vestibular schwannoma surgery is variable and is not as high as expected, possibly due to injuries to the posterior semicircular canal while exposing the tumor. The aim of this study was to estimate the risk of posterior semicircular canal injuries using temporal bone computed tomography (CT) scan findings. Temporal bone CT scans of 30 patients selected between 2013 and 2015 were studied. The median age of the patients was 40 years. Two planes were studied: (1) the axial plane that shows the common crus of the posterior semicircular canal and (2) the coronal plane that shows the two crura of the posterior semicircular canal. Five lines were drawn and four angles and three distances were measured. In this study, we divided the patients into three groups consisting of 10 patients each: (1) patients with no evidence of inflammatory or neoplastic disease, (2) those with chronic ear disease, and (3) those with vestibular schwannomas. The portion of the internal auditory canal that was exposed by drilling while preserving the posterior semicircular canal was 53 to 64% and 61 ± 9% in whole temporal bones in the three groups. The mean angle of vision with an endoscope was less than 105° in 56% of cases, which means even with a 30° endoscope, the fundus could not be visualized. Therefore, according to our data, it seemed impossible to expose the whole length of the internal auditory canal from the porus to the fundus without causing injury to the posterior semicircular canal. However, the use of endoscopes may help to prevent injury.

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