Endolymphatic Duct Violation During Retrosigmoid Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study

Sulman, Cecille G.; Vecchiotti, Mark A.; Semaan, Maroun T.; Lewin, Jonathan S.; Megerian, Cliff A.

doi:10.1097/01.mlg.0000147923.19852.3a

Cited by 12 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postoperative hearing loss can be categorized as immediate or delayed. In the case of delayed hearing loss, some theories have been examined, such as the endolymphatic duct violation and damage to the cochlear nerve's vascular supply [35]. The former has been proven hard to avoid, as it requires very delicate manipulation, often too delicate for the existing technology.…”

Section: Hearing Lossmentioning

confidence: 99%

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Charalampakis¹,

Koutsimpelas²,

Gouveris³

et al. 2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The retrosigmoid (suboccipital) approach is one of four surgical approaches for the treatment of vestibular schwannomas (acoustic neuromas). It is increasingly used by otologic surgeons, and in experienced hands is associated with improved results and more limited complications. Mortality rates are minimal and often zero, while postoperative sequelae, on the other hand, are not rare. In order to not only save the patient's life, but also to assure good quality of life after the surgery, one must consider many different aspects of management of the respective complications. In this review the issues of current management of CSF leak and meningitis, facial paresis, headache, hearing loss, unsteadiness, disequilibrium, vertigo, tinnitus, cerebellar and brain stem injuries or abscess, vascular complications and venous air embolism after retrosigmoid approach for removal of vestibular schwannomas are presented.

show abstract

Section: Hearing Lossmentioning

confidence: 99%

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Charalampakis¹,

Koutsimpelas²,

Gouveris³

et al. 2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Clemis 3 subsequently hypothesized in 1983 that despite immediate hearing preservation, complete tumor removal may result in ELD injury and may be responsible for delayed HL. The present study is a continuation of the report by Sulman et al 7 in which cadaveric temporal bones underwent high-resolution multislice computer tomography (HRMCT) before and after retrosigmoid approach to dissection of the IAC. That study showed that 24% of temporal bones did have violation of the ELD and served as a potential mechanism for long-term hearing decline following retrosigmoid dissection.…”

Section: Introductionmentioning

confidence: 77%

Endolymphatic Duct Status During Middle Fossa Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study

et al. 2006

Self Cite

View full text Add to dashboard Cite

The ELD is not vulnerable to injury during IAC dissection using the middle fossa approach. A previous radiographic study has shown that the ELD is violated in 24% of temporal bones during retrosigmoid dissection of the IAC. These findings support and may help explain other outcome studies that show that long-term hearing results are superior with the use of the middle fossa approach when compared to results following retrosigmoid dissection.

show abstract

“…One of the hypotheses puts an emphasis on the significance of preserving the ED during IAM drilling. Sulman et al [ 10 ] dissected 21 human temporal bones for the analysis of ED or ES injury during a suboccipital approach. The material was examined with the use of HRCT.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the radiological planning for hearing preservation surgery in vestibular schwannoma

et al. 2016

View full text Add to dashboard Cite

PurposeDuring vestibular schwannoma surgery there is a risk of endolymphatic duct and sac injury, which may cause a loss or a deterioration of hearing. The goal of the study was to evaluate the empirical utility of presurgical planning using CT with the bone window for the hearing preservation surgery.MethodsThe study was performed on 14 human temporal bones. CT scans with the bone window were obtained in the standard position. Safe drilling line was evaluated and after that drilling distances were analysed: the lateral drilling distance, total length of internal acoustic meatus, drilled length of internal acoustic meatus. After this, a surgical exposure was performed, using size of a drill tip as measuring scale. The dura was excised and endolymphatic duct was injected with a latex. Revision of the internal acoustic meatus was performed with the use of a microscope.ResultsMean results of safe drilling coefficients were: lateral drilling distance: 10 ± 2 mm, total length of internal acoustic meatus: 9 ± 2 mm, drilled length of internal acoustic meatus: 7 ± 2 mm. In all cases, no endolymphatic duct injury was observed.ConclusionsPreoperative radiological planning using the safe drilling coefficients is of value for the hearing preservation surgery in vestibular schwannoma. The size of the drilling tip may be used as an intraoperative measuring scale during this procedure. However, CT with a bone window is a necessary tool for the purposes of this procedure.

show abstract

Endolymphatic Duct Violation During Retrosigmoid Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study

Cited by 12 publications

References 14 publications

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management

Endolymphatic Duct Status During Middle Fossa Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study

Usefulness of the radiological planning for hearing preservation surgery in vestibular schwannoma

Contact Info

Product

Resources

About