A Re-Examination of Macewen's Triangle as a Surface Marking for the Mastoid Antrum

Pickard, Brian

doi:10.1017/s0022215100059892

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…Work by Pickard (1962) also suggested that there was a discrepancy between the triangle and the mastoid antrum, the antrum lying approximately a quarter of an inch (6.25 mm.) above the surface markings of the triangle.…”

Section: Discussionmentioning

confidence: 99%

A radiological assessment of the usefulness of Macewen's triangle as a surgical landmark

Milton

Cousins

1986

J. Laryngol. Otol.

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Section: Discussionmentioning

confidence: 99%

A radiological assessment of the usefulness of Macewen's triangle as a surgical landmark

Milton

Cousins

1986

J. Laryngol. Otol.

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“…(4) Total removal of the temporal bone surface facing the cerebral temporal lobe ( n = 1). (5) Removal of the suprameatal triangle (MacEwen's triangle; Pickard, ; Milton and Cousins, ) bone ( n = 2). After trials, the most time‐saving and fail‐safe of these five methods was selected.…”

Section: Methodsmentioning

confidence: 99%

Time‐saving and fail‐safe dissection method for vestibulocochlear organs in gross anatomy classes

et al. 2017

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Because the vestibulocochlear organs are tiny and complex, and are covered by the petrous part of the temporal bone, they are very difficult for medical students to dissect and visualize during gross anatomy classes. Here, we report a time-saving and fail-safe procedure we have devised, using a hand-held hobby router. Nine en bloc temporal bone samples from donated human cadavers were used as trial materials for devising an appropriate procedure for dissecting the vestibulocochlear organs. A hand-held hobby router was used to cut through the temporal bone. After trials, the most time-saving and fail-safe method was selected. The performance of the selected method was assessed by a survey of 242 sides of 121 cadavers during gross anatomy classes for vestibulocochlear dissection. The assessment was based on the observation ratio. The best procedure appeared to be removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof. The whole procedure was completed within two dissection classes, each lasting 4.5 hr. The ratio of surveillance for the chorda tympani and three semicircular canals by students was significantly improved during 2013 through 2016. In our dissection class, "removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof" was the best procedure for students in the limited time available. Clin. Anat. 30:703-710, 2017. © 2017Wiley Periodicals, Inc.

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“…These two cuts define Macewen's suprameatal triangle (Figure 1). The creation of a properly defined attack triangle with a large cutting burr is a critical initial step, enabling the subsequent dissection passages to proceed smoothly [10][11][12]. Inadequate triangle formation, which was found in first-year ENT residents, can significantly compromise subsequent dissection steps, potentially leading to difficulty in locating crucial landmarks.…”

Section: How To Avoid Mistakes In Step 1: Creation Of the Mastoid Cavitymentioning

confidence: 99%

“…Inadequate triangle formation, which was found in first-year ENT residents, can significantly compromise subsequent dissection steps, potentially leading to difficulty in locating crucial landmarks. Next, wide cortical removal and thinning of the posterior canal wall should be achieved before penetrating the antrum [9,10]. The posterior canal wall should be thinned to the point that the shadow of an instrument can be seen through the bone when the canal skin is elevated (Figure 2).…”

Section: How To Avoid Mistakes In Step 1: Creation Of the Mastoid Cavitymentioning

confidence: 99%

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Motta,

Massimilla,

Allosso

et al. 2024

JPM

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Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear surgery, which includes the management of inflammatory pathology, hearing rehabilitation, and also cognitive decline prevention surgery. The primary objective of this study was to identify common mistakes and critical passages during the initial steps of temporal bone dissection, specifically cortical mastoidectomy and posterior tympanotomy. Methods: A survey among 100 ENT residents was conducted, gathering insights into the most prevalent errors encountered during their training to uncover the most challenging aspects faced by novice surgeons during these procedures. Results: The most common mistakes included opening the dura of the middle cranial fossa (MCF), injury of the sigmoid sinus (SS), chorda tympani (CT), and facial nerve (FN) injury while performing the posterior tympanotomy. The most important critical steps to prevent mistakes are related to the absence of wide exposure during cortical mastoidectomy and the consequent impossibility of identifying the landmarks of the facial recess before performing posterior tympanotomy. Injury of these structures was more common in younger surgeons and in the ones who performed less than five temporal bone dissection courses. Conclusions: Numerous temporal bone dissections on cadavers are mandatory for ENT residents looking forward to performing middle ear surgery.

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A Re-Examination of Macewen's Triangle as a Surface Marking for the Mastoid Antrum

Cited by 5 publications

References 2 publications

A radiological assessment of the usefulness of Macewen's triangle as a surgical landmark

A radiological assessment of the usefulness of Macewen's triangle as a surgical landmark

Time‐saving and fail‐safe dissection method for vestibulocochlear organs in gross anatomy classes

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

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