Image-interactive orientation in the middle cranial fossa approach to the internal auditory canal:An experimental study
1997; Taylor & Francis; Volume: 2; Issue: 1 Linguagem: Inglês
10.1002/(sici)1097-0150(1997)2
ISSN1097-0150
AutoresFotios D. Vrionis, Jon H. Robertson, Kevin T. Foley, Gale Gardner,
Tópico(s)Facial Nerve Paralysis Treatment and Research
ResumoApproaches through the middle cranial fossa directed at reaching the internal auditory canal (IAC) invariably employ exposure of the geniculate ganglion, the superior semicircular canal (SSC) or the epitympanum. This involves risk to the facial nerve and hearing apparatus. To minimize this risk, we conducted a laboratory study on 9 cadaver temporal bones by using an image-interactive guidance system (StealthStationTM) to provide topographic orientation in the middle fossa approach. Surface anatomic fiducials such as the umbo of the tympanic membrane, Henle's spine, the root of the zygoma and various sutures were used as fiducials for registration of CT-images of the temporal bone. Accurate localization of the IAC was achieved in every specimen. Mean target localization error varied from 1.20 to 1.38 mm for critical structures in the temporal bone such as the apex of the cochlea, crus commune, ampula of the SSC and facial hiatus. Our results suggest that frameless stereotaxy may be used as an alternative to current methods in localizing the IAC in patients with small vestibular schwannomas or intractable vertigo undergoing middle fossa surgery. Comp Aid Surg Comp Aid Surg 2:34–41 (1997). © 1997 Wiley-Liss, Inc.
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