Judith S Kempfle1, Benjamin Fiorillo2, Vivek V Kanumuri3, Samuel Barber2, Albert S B Edge3, Marybeth Cunnane3, Aaron K Remenschneider4, Daniel J Lee3, Elliott D Kozin3. 1. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology, University Tübingen Medical Center, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany. Electronic address: Judith_kempfle@meei.harvard.edu. 2. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, USA; Tufts University School of Medicine, Boston, MA, USA. 3. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA. 4. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, USA; Department of Otolaryngology, UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA.
Abstract
PURPOSE: A transcanal endoscopic infracochlear surgical approach to the internal auditory canal (IAC) in a human temporal bone model has previously been described. However, the proportion of patients with favorable anatomy for this novel surgical technique remains unknown. Herein, we perform a quantitative analysis of the transcanal endoscopic infracochlear corridor to the IAC based on computed tomography. MATERIALS AND METHODS: High resolution computed tomography scans of adult temporal bones were measured to determine the accessibility of the IAC when using an endoscopic transcanal, cochlear-sparing surgical corridor. RESULTS: This approach to the IAC was feasible in 92% (35 of 38) specimens based on a minimum distance of 3mm between the basilar turn of the cochlear and the great vessels (jugular bulb and carotid artery). CONCLUSIONS: Infracochlear access to the IAC is feasible in the majority of adult temporal bones and has implications for future hearing preservation drug delivery approaches to the IAC.
PURPOSE: A transcanal endoscopic infracochlear surgical approach to the internal auditory canal (IAC) in a human temporal bone model has previously been described. However, the proportion of patients with favorable anatomy for this novel surgical technique remains unknown. Herein, we perform a quantitative analysis of the transcanal endoscopic infracochlear corridor to the IAC based on computed tomography. MATERIALS AND METHODS: High resolution computed tomography scans of adult temporal bones were measured to determine the accessibility of the IAC when using an endoscopic transcanal, cochlear-sparing surgical corridor. RESULTS: This approach to the IAC was feasible in 92% (35 of 38) specimens based on a minimum distance of 3mm between the basilar turn of the cochlear and the great vessels (jugular bulb and carotid artery). CONCLUSIONS: Infracochlear access to the IAC is feasible in the majority of adult temporal bones and has implications for future hearing preservation drug delivery approaches to the IAC.
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