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Related Experiment Videos

Transcanal approach to the singular nerve.

Maria Izabel Kos1, Georg Feigl, Friedrich Anderhuber

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland. izabel.kos@hcuge.ch

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|June 23, 2006
PubMed
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Transcanal singular neurectomy is a feasible surgical approach for intractable vertigo, with a 98% success rate in reaching the singular nerve canal without damaging the inner ear. This technique offers a potential solution for a rare condition where surgical intervention is necessary.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Anatomy

Background:

  • Intractable benign paroxysmal positional vertigo (BPPV) is rare and often requires surgical intervention.
  • Transcanal singular neurectomy is a complex procedure with reported risks of hearing loss and persistent vertigo.
  • Previous anatomical and surgical reports have yielded conflicting results regarding the accessibility of the singular nerve via the external auditory canal.

Purpose of the Study:

  • To evaluate the feasibility of performing singular neurectomy through the transcanal approach.
  • To clarify anatomical relationships and explain discrepancies in prior literature.
  • To determine if the singular nerve canal can be accessed without compromising the labyrinth.

Main Methods:

  • Anatomical dissection of 100 human head halves.

Related Experiment Videos

  • Identification and opening of the singular nerve canal from the internal auditory canal and posterior semicircular canal via a posterior fossa approach.
  • Dissection of the singular nerve canal through the external auditory canal at the round window niche floor.

    • Main Results:

    • The singular nerve canal was successfully accessed in 98% of cases via the transcanal approach.
    • In 90% of cases, the transection was medial to the posterior ampullary nerve, and in 8%, at its emergence.
    • The round window membrane and bony labyrinth remained intact in these 98 cases; access was not achieved in 2%.

    Conclusions:

    • Transcanal singular neurectomy is anatomically feasible in 98% of cases without labyrinthine or round window membrane damage.
    • The technical difficulty and rarity of indications may explain why surgeons have historically abandoned this procedure.
    • Mastery of this technique is crucial to avoid complications such as sensorineural hearing loss.