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The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Quantitative imaging analysis of transcanal endoscopic Infracochlear approach to the internal auditory canal
Judith S Kempfle1, Benjamin Fiorillo2, Vivek V Kanumuri3
1Department 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.
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.
