The endoscopic anatomy of the middle ear approach to the fundus of the internal acoustic canal

Noritaka Komune, Satoshi Matsuo, Koichi Miki, Albert L. Rhoton

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE The application of the endoscope in the lateral skull base increases the importance of the middle ear cavity as the corridor to the skull base. The aim of this study was to define the middle ear as a route to the fundus (lateral end) of the internal acoustic canal and to propose feasible landmarks to the fundus. METHODS This was a cadaveric study; 34 adult cadaveric temporal bones and 2 dry bones were dissected with the aid of the endoscope and microscope to show the anatomy of the transcanal approach to the middle ear and fundus of the internal acoustic canal. RESULTS In the middle ear cavity, the cochleariform process is one of the key landmarks for accessing the fundus of the internal acoustic canal. The triangle formed by the anterior and posterior edges of the overhang of the round window and the cochleariform process provides a landmark to start drilling the bone to access the fundus of the internal acoustic canal. CONCLUSIONS The external acoustic canal and middle ear cavity combined, using endoscopic guidance, can provide a route to the fundus of the internal acoustic canal. A triangular landmark crossing the promontory has been described for reaching the meatal fundus. This transcanal approach requires an understanding of the relationship between the middle ear cavity and the fundus of the internal acoustic canal and provides a potential new area of cooperation between otology and neurosurgery for accessing pathology in this and the bordering skull base.

Original languageEnglish
Pages (from-to)1974-1983
Number of pages10
JournalJournal of Neurosurgery
Volume126
Issue number6
DOIs
Publication statusPublished - Jun 2017

Fingerprint

Middle Ear
Acoustics
Anatomy
Skull Base
Endoscopes
Bone and Bones
Ear Canal
Temporal Bone
Otolaryngology
Neurosurgery
Pathology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

The endoscopic anatomy of the middle ear approach to the fundus of the internal acoustic canal. / Komune, Noritaka; Matsuo, Satoshi; Miki, Koichi; Rhoton, Albert L.

In: Journal of Neurosurgery, Vol. 126, No. 6, 06.2017, p. 1974-1983.

Research output: Contribution to journalArticle

Komune, Noritaka ; Matsuo, Satoshi ; Miki, Koichi ; Rhoton, Albert L. / The endoscopic anatomy of the middle ear approach to the fundus of the internal acoustic canal. In: Journal of Neurosurgery. 2017 ; Vol. 126, No. 6. pp. 1974-1983.
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