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What is the arcuate eminence?
A Faure1, H Masse, M Gayet-Delacroix
1Service de Neurotraumatologie, Hôtel-Dieu, CHU de Nantes, Place Alexis Ricordeau, 44093, Nantes Cedex 1, France.
Surgical and Radiologic Anatomy : SRA
|June 13, 2003
Summary
The arcuate eminence (AE) is an unreliable landmark for the superior semicircular canal (SSCC) during surgery. This study found the AE is only a good guide in 37% of cases, making it unsuitable for acoustic neuroma surgery.
Area of Science:
- Neurosurgery
- Anatomy
- Radiology
Background:
- The suprapetrous approach to the internal acoustic meatus is crucial for acoustic neuroma extirpation.
- Accurate anatomical landmarks are vital for surgical success and patient safety.
Purpose of the Study:
- To evaluate the arcuate eminence (AE) as a reliable landmark for the superior semicircular canal (SSCC).
- To assess the AE's utility in the suprapetrous approach for acoustic neuroma surgery.
Main Methods:
- Analysis of 100 homogeneous CT scans of the petrous temporal bone.
- Direct measurements on 1 mm thick coronal sections.
- Correlation with MRI findings for temporal sulcus imprints.
Main Results:
- The AE was absent in 15% of cases.
- AE correctly identified the SSCC relief in only 37% of cases.
- AE-SSCC correspondence varied, with significant bone thickness between AE and cortex in some cases (0.5-5 mm).
- AE was not a good landmark in 48% of cases.
- AE does not routinely correlate with temporal sulcus imprints on MRI.
Conclusions:
- The arcuate eminence is an unreliable surgical landmark for the superior semicircular canal.
- The AE's variability and inconsistent relationship with the SSCC preclude its routine use in suprapetrous approaches.
- Surgical planning for acoustic neuroma extirpation should not solely rely on the arcuate eminence.