Surgical anatomy of the transcanal infracochlear approach

Cömert, Ela; Cömert, Ayhan

doi:10.1007/s00405-021-06635-6

Cited by 2 publications

(5 citation statements)

References 21 publications

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“…In cases of petrous apex cholesterol granuloma with serviceable hearing, a variety of surgical approaches have been described, including infralabyrinthine and endoscopic-endonasal approaches [2, 7, 8]. They are limited by a high JB and better suited for more medially placed lesions in superior and anterior-inferior petrous apex since anterior approaches may require paraclival ICA lateralization [6, 9, 10]. The middle fossa approach is no longer recommended due to limited drainage and aeration ability, the necessity of a craniotomy and temporal lobe retraction [7, 8].…”

Section: Discussionmentioning

confidence: 99%

“…The middle fossa approach is no longer recommended due to limited drainage and aeration ability, the necessity of a craniotomy and temporal lobe retraction [7, 8]. Infratemporal type B and translabyrinthine approaches should only be considered in cases of profound hearing loss, involvement of critical neurovascular structures, or recurrent lesions [4, 6].…”

Section: Discussionmentioning

confidence: 99%

“…Our choice for surgical approach was limited by the fact that the patient is a voice professional, and had normal hearing on the side of the lesion. She had a high jugular bulb (JB) on the left side, and the internal carotid artery (ICA) was positioned immediately anterior to the granuloma in the sphenoid sinus [6]. We decided to use the transcanal infracochlear approach because it offers the advantages of preservation of normal external and middle ear conduction mechanism and reexploration through an inferior myringotomy, provided there is a minimum of 4 mm between the JB and the cochlea (Fig.…”

Section: Case Reportmentioning

confidence: 99%

“…We decided to use the transcanal infracochlear approach because it offers the advantages of preservation of normal external and middle ear conduction mechanism and reexploration through an inferior myringotomy, provided there is a minimum of 4 mm between the JB and the cochlea (Fig. 3) [6].…”

Section: Case Reportmentioning

confidence: 99%

“…The procedure was completed through a standard postauricular incision and a transcanal approach. The infracochlear corridor is defined by the cochlea or round window superiorly, ICA anteriorly, and JB inferiorly and the mastoid portion of the facial nerve posteriorly [6]. Using a small diamond burr, the air cells below the cochlea were removed to expose the ICA and the JB.…”

Section: Case Reportmentioning

confidence: 99%

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Surgical Considerations in Addressing Cholesterol Granuloma of the Petrous Apex through an Infracochlear Approach

Košec¹,

Prnjak²,

Tomljenović³

et al. 2023

ORL

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Cholesterol granuloma of the petrous bone is a foreign body giant cell reaction to cholesterol deposits with symptoms including hearing loss, vestibular dysfunction, and cranial nerve deficit as a result of cystic mass compression. Surgical treatment is often difficult to plan due to limited access to the lesion and possible injury to surrounding structures. We report on a case of petrous apex cholesterol granuloma drainage through an infracochlear approach. A 27-year-old female patient presented with acute diplopia due to left-sided abducens paralysis. Multislice computed tomography (MSCT) and magnetic resonance (MR) imaging described a 3.5-cm well-marginated lesion in petrous bone apex, compressing the left abducens nerve at the point of entry into the cavernous sinus, corresponding to cholesterol granuloma. The patients was surgically treated through a transcanal infracochlear approach, since preserving the external and middle ear conduction mechanisms was paramount for the patient. The patient was discharged on the second postoperative day and diplopia resolved within 5 days postoperatively. Six months after the surgery, her hearing on the left side is normal, and she remains symptom-free. This case underpins the value of preoperative planning when approaching the petrous apex, an anatomically complex area due to abundance of important neurovascular structures crowded in a narrow and confined region.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 3 more Smart Citations

Surgical Considerations in Addressing Cholesterol Granuloma of the Petrous Apex through an Infracochlear Approach

Košec¹,

Prnjak²,

Tomljenović³

et al. 2023

ORL

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Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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Introduction: The retroauricular approach (RA) has been developed in order to expose the temporomandibular joint in a way that minimizes the risk of injury to the facial nerve and masks the postoperative scar. One of its characteristics is an excellent posterolateral view of the mandibular head, which allows for the preservation of the lateral temporomandibular joint ligaments in the course of open intracapsular surgery. Aim: The aim of this study is to systematically review the currently used variants and modifications of RA. Materials and Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was performed based on the PubMed and BASE search engines; furthermore the authors performed a more detailed search in the Google Scholar article database as well as a loop search within the references of papers included in the systematic review. Results: Searching medical articles databases, Google Scholar, and references yielded a total of 85 records. First the titles and abstracts were blindly screened which was followed by a full-text eligibility check resulting in eventually including and qualifying 7 articles for detailed analysis. Discussion: All known variants and modifications of RA are characterized by high safety for the facial nerve and an aesthetically hidden scar. There were no reports of auricle necrosis in the collected material. Conclusions: In this systematic review, 2 variants and 2 modifications of RA that allow for open temporomandibular joint surgery have been identified; all of them together cover a large spectrum of indications for joint surgery, including reposition and osteosynthesis of mandibular head fractures, eminoplasty, or eminectomy and treatment of some forms of ankylosis.

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Surgical anatomy of the transcanal infracochlear approach

Cited by 2 publications

References 21 publications

Surgical Considerations in Addressing Cholesterol Granuloma of the Petrous Apex through an Infracochlear Approach

Surgical Considerations in Addressing Cholesterol Granuloma of the Petrous Apex through an Infracochlear Approach

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

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