Image-interactive orientation in the middle cranial fossa approach to the internal auditory canal

An experimental study

Fotios D. Vrionis, Jon H. Robertson, Kevin Foley, Gale Gardner

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Approaches 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 (StealthStation(TM)) 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.

Original languageEnglish (US)
Pages (from-to)34-41
Number of pages8
JournalComputer Aided Surgery
Volume2
Issue number1
DOIs
StatePublished - Aug 20 1997

Fingerprint

Middle Cranial Fossa
Temporal Bone
Canals
Semicircular Canals
Geniculate Ganglion
Bone
Fiducial Markers
Neuronavigation
Sound Localization
Zygoma
Tympanic Membrane
Acoustic Neuroma
Cochlea
Vertigo
Facial Nerve
Cadaver
Sutures
Hearing
Spine
Audition

All Science Journal Classification (ASJC) codes

  • Surgery
  • Computer Science Applications
  • Family Practice

Cite this

Image-interactive orientation in the middle cranial fossa approach to the internal auditory canal : An experimental study. / Vrionis, Fotios D.; Robertson, Jon H.; Foley, Kevin; Gardner, Gale.

In: Computer Aided Surgery, Vol. 2, No. 1, 20.08.1997, p. 34-41.

Research output: Contribution to journalArticle

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