Image-guided localization of the internal auditory canal via the middle cranial fossa approach

Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
Robert Sean MillerBradley W Kesser

Abstract

We sought to determine the accuracy of an electromagnetic image guidance surgical navigation system in localizing the midpoint of the internal auditory canal (IAC) and other structures of the temporal bone through the middle cranial fossa approach. Seven fresh cadaveric whole heads were dissected via a middle cranial fossa approach. High-resolution CT scans were used with an InstaTrak 3500 Plus electromagnetic image guidance system (General Electric, Fairfield, CT). We evaluated the accuracy of identifying several middle cranial fossa landmarks including the midpoint of the IAC; the labyrinthine segment of the facial nerve; and the arcuate eminence, the carotid artery, and foramen spinosum. We were able to identify the middle of the IAC within 2.31 mm (range 0.65-7.52 mm, SD 2.39 mm). The arcuate eminence could be identified within 1.86 mm (range 1.49-2.37 mm, SD 0.36 mm). We noted some interference when the handpiece was within 6 to 8 cm of the microscope. Although computer-aided navigational tools are no substitute for thorough knowledge of temporal bone anatomy, we found the InstaTrak system reliable in identifying the midpoint of the IAC to within 2.4 mm through a middle fossa approach.

References

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Citations

Dec 15, 2006·Stereotactic and Functional Neurosurgery·Joshua M Rosenow, W Keith Sootsman
Aug 1, 2012·PloS One·Eduard H J VoormolenJan Willem Berkelbach van der Sprenkel
Jan 19, 2013·Iranian Journal of Radiology : a Quarterly Journal Published by the Iranian Radiological Society·Sergio Ricardo MarquesHenrique Lederman
Oct 2, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Cheng-Mao ChengChin-Liang Lin
Aug 15, 2013·Acta Oto-laryngologica·Daniele BernardeschiOlivier Sterkers
May 7, 2016·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Eric SoteriouTanja Daniela Grauvogel
Jun 16, 2016·The Laryngoscope·Noritaka KomuneAlbert L Rhoton

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Methods Mentioned

BETA
dissections
dissection

Software Mentioned

InstaTrak
InstaTrak IGS
InstaTrak 3500 Plus
VectorVision

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