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Updated: Feb 11, 2026

Extracting the Cochlea from a Human Temporal Bone: A Cadaveric Protocol
Published on: August 18, 2023
Clinical Implications of the Association Between Temporal Bone Tegmen Defects and Superior Semicircular Canal
Ophir Handzel1, Adi Brenner-Ullman2, Oren Cavel1
1Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery.
Objective:
To discuss the clinical implications of the association between temporal bone tegmen dehiscence (TD) necessitating surgical correction and the adjacent dehiscent superior semicircular canal (SSCD).
Study Design:
Retrospective.
Setting:
Tertiary referral center.
Patients:
Sixteen patients with idiopathic TD, with or without SSCD, requiring surgical correction.
Interventions:
Corrective surgery for TD. High-resolution temporal bone-targeted computed tomography.
Main Outcome Measures:
The impact of the minimal distance between TD and SSCD or the arcuate eminence on the choice of surgical approach to TD.
Results:
The patients' median age was 58 years and 5 were males. The median body mass index was 31.8 kg/m. The average distance from the TD and the SSC was 4.9 mm (range 2.1-14.2 mm). Three of the 14 patients who were operated via a temporal craniotomy to fix a cerebrospinal fluid-leaking TD required plugging of an asymptomatic SSCD due to its close proximity (3-5 mm) to the defect, and two of them had relatively protracted vestibular recuperation. Two patients were operated via a transmastoid approach for sealing a cerebrospinal fluid-leaking TD coexisting with a bilateral asymptomatic SSCD. No patient had a hearing loss.
Conclusion:
The close proximity of a TD and an SSCD might not allow selective exposure. As a result, asymptomatic SSCD may become symptomatic during TD correction via the temporal craniotomy approach. The need to plug an asymptomatic SSCD that is proximal to a TD should be factored in planning for surgery and rehabilitation. The choice of surgical approach (middle fossa vs. transmastoid) could be influenced by this relationship, especially in cases of bilateral lesions.
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