Internal Auditory Canal
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2021 ◽  
Vol 5 (2) ◽  
pp. V5
Felipe Constanzo ◽  
Bernardo Correa de Almeida Teixeira ◽  
Mauricio Coelho Neto ◽  
Ricardo Ramina

Inadvertent laceration of the jugular bulb is a potentially serious complication of the retrosigmoid transmeatal approach to vestibular schwannomas. Here, the authors present the case of a 51-year-old woman with a right Hannover T4a vestibular schwannoma and bilateral high-riding jugular bulb, which was opened during drilling of the internal auditory canal (IAC). They highlight the immediate management of this complication, technical nuances for closing the defect without occluding the jugular bulb, and modifications of the standard technique needed to continue surgical resection. The video can be found here:

2021 ◽  
Vol 5 (2) ◽  
pp. V4
Florian Roser ◽  
Tanmoy Maiti ◽  
Mohamed Samy Elhammady

The present surgical video demonstrates safe opening of the internal auditory canal (IAC) during vestibular schwannoma surgery via a retrosigmoid approach in the sitting position. Resection of the intrameatal portion of a tumor is important for progression-free survival. Preoperative thin-sliced CT revealed a high-riding jugular bulb obscuring the trajectory. After dural opening, the IAC was approached anteriorly and superiorly. The posterior margin of IAC drilling was above the Tubingen line. Drilling was performed under continuous jugular compression. The vein was pushed down to augment visibility. An angled endoscope was helpful. IAC can be drilled safely in a high-riding jugular bulb with the technique mentioned in the video. The video can be found here:

2021 ◽  
Vol 5 (2) ◽  
pp. V13
Claudio H. F. Vidal ◽  
Yoav Hahn ◽  
Mariana C. Leal ◽  
Kiara Medeiros ◽  
Gabriela F. Hazin ◽  

Hearing preservation is a cornerstone in the management of intracanalicular vestibular schwannomas. This video demonstrates a middle fossa approach to an intracanalicular schwannoma and highlights some technical and anatomical nuances relevant to the procedure. The patient had sustained hearing preservation in the postoperative period. There are potential benefits in favor of the middle fossa when the tumor reaches the fundus of the internal auditory canal, but the surgeon’s individual experience plays a decisive role in the choice of approach. The video can be found here:

2021 ◽  
Vol 20 (4) ◽  
Nik Adilah Nik Othman ◽  
Nur Saadah Mohamad ◽  
Ahmad Aizuddin Mohamad Jamali ◽  
Mohd Shafie Abdullah ◽  
Mohd Khairi Md Daud

Duplication of the internal auditory canal is a rare entity. It can be unilateral or bilateral involvement and usually found during an investigation of sensorineural hearing loss or facial nerve palsy. We report this image finding in a child with Down syndrome with bilateral profound sensorineural hearing loss. There was no facial nerve palsy. We highlight the rarity of this image finding and the importance of imaging for detection of middle and inner ear abnormality in a case of congenital sensorineural hearing loss as it helps in decision making for the suitable treatment. Keywords: Duplicate IAC; Bilateral Duplicate IAC; sensorineural hearing loss; Down syndrome

2021 ◽  
pp. 014556132110471
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang

Objectives This study aimed to investigate the perilymph metabolism by analyzing the 3D real IR MR findings in acoustic neuroma (AN) after intravenous administration of gadolinium (Gd). Methods Eleven patients (6 men and 5 women) diagnosed with AN were included, and 3D real IR MRI was performed 4 hours after intravenous Gd injection. The signal intensity and details of inner ear, tumor, and internal auditory canal (IAC) by MRI were analyzed. Results Four patients had tumors confined to the IAC, and 5 had tumors that extended to the cerebellopontine angle cistern. The signal intensity of the cochlea, vestibule, and IAC fundus was conspicuously enhanced in 3D real IR images than the control side. One patient had a tumor in the cochlea, in which the signal intensity of the semicircular canal and vestibule was increased. One patient had an intravestibular tumor in which the signal intensity of the semicircular canal was increased and the cochlea had endolymphatic hydrops in the affected ear. Conclusions The synchronously increased signal intensity in the inner ear and IAC may indicate that IAC may serve as a channel for removal of the perilymph in the inner ear; the blockage by the tumor may have changed the hydrodynamics of the perilymph to cause a longer retention of Gd in the inner ear.

Caio A. Neves ◽  
Christoph Leuze ◽  
Alejandro M. Gomez ◽  
Nassir Navab ◽  
Nikolas Blevins ◽  

AbstractWhile medical imaging data have traditionally been viewed on two-dimensional (2D) displays, augmented reality (AR) allows physicians to project the medical imaging data on patient's bodies to locate important anatomy. We present a surgical AR application to plan the retrosigmoid craniotomy, a standard approach to access the posterior fossa and the internal auditory canal. As a simple and accurate alternative to surface landmarks and conventional surgical navigation systems, our AR application augments the surgeon's vision to guide the optimal location of cortical bone removal. In this work, two surgeons performed a retrosigmoid approach 14 times on eight cadaver heads. In each case, the surgeon manually aligned a computed tomography (CT)-derived virtual rendering of the sigmoid sinus on the real cadaveric heads using a see-through AR display, allowing the surgeon to plan and perform the craniotomy accordingly. Postprocedure CT scans were acquired to assess the accuracy of the retrosigmoid craniotomies with respect to their intended location relative to the dural sinuses. The two surgeons had a mean margin of davg = 0.6 ± 4.7 mm and davg = 3.7 ± 2.3 mm between the osteotomy border and the dural sinuses over all their cases, respectively, and only positive margins for 12 of the 14 cases. The intended surgical approach to the internal auditory canal was successfully achieved in all cases using the proposed method, and the relatively small and consistent margins suggest that our system has the potential to be a valuable tool to facilitate planning a variety of similar skull-base procedures.

2021 ◽  
Vol 26 (3) ◽  
pp. 65-66
Simona Șerban ◽  
Arthur Weisman

Abstract The vascular loop refers to a trajectory abnormality of the antero-inferior cerebellar artery or its branch in the internal auditory canal. The Chavda radiological classification identifies three types of trajectory depending on the depth of penetration of the loop at the level of the internal auditory canal. The article presents the case of a 26-year-old patient admitted to the ENT department for left ear sudden sensorineural hearing loss and dizziness. The 3D Fiesta-C axial sequence MRI shows the presence of the vascular loop inside the internal auditory canal, without exceeding half of it. The hearing loss had an unfavourable evolution, without recovery after treatment with steroids and vasodilators. Sudden sensorineural hearing loss may be a consequence of the presence of the vascular loop in the internal auditory canal. The prognosis for recovery from hearing loss is poor if the loop is at least type II.

2021 ◽  
Vol Publish Ahead of Print ◽  
Vivian F. Kaul ◽  
Zachary G. Schwam ◽  
Peter Filip ◽  
Jeffrey Laitman ◽  
George B. Wanna

2021 ◽  
Arianna Di Stadio ◽  
Laura Dipietro ◽  
Daniela Messineo ◽  
Massimo Ralli ◽  
Giampietro Ricci ◽  

2021 ◽  
Vol Publish Ahead of Print ◽  
Lisa Zhang ◽  
Deepa Galaiya ◽  
Christopher M. Jackson ◽  
Rafael J. Tamargo ◽  
Michael Lim ◽  

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