Premium
Anatomic basis for labyrinthine preservation during posterior fossa acoustic tumor surgery
Author(s) -
Kartush Jack M.,
Telian Steven A.,
Graham Malcolm D.,
Kemink John L.
Publication year - 1986
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198609000-00016
Subject(s) - anatomy , posterior semicircular canal , medicine , vestibular system , auditory canal , vestibular aqueduct , semicircular canal , dissection (medical) , membranous labyrinth , inner ear , posterior fossa , radiology
Earlier diagnosis of acoustic tumors promises to increase our opportunity to identify patients with serviceable hearing. Critical to a posterior fossa transmeatal approach for acoustic tumor resection is preservation of the underlying labyrinth. Although the labyrinth has been recognized as a limiting factor in exposure of tumor in the internal auditory canal, few reports have detailed the microscopic surgical anatomy posterior to the internal auditory canal. An anatomic study was undertaken to determine consistent relationships between critical structures within the temporal bone relevant to hearing preservation surgery. The results of this study indicate that, whereas topographic landmarks are helpful for orientation, the more consistent relationship of the labyrinth to the vestibular aqueduct and singular canal allows a more accurate localization of the underlying labyrinth. Although the vestibule frequently prevents direct visualization of the transverse crest, a dissection based upon the microsurgical anatomy will maximize visualization of the lateral fundus while preserving the integrity of the labyrinth.