Download PDF
CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2023; 84(04): 384-394
DOI: 10.1055/a-1786-9026
Original Article

Phenotypical Variability of the Internal Acoustic Canal in the Middle Cranial Fossa Surgery

Maryna Al-Fauri Kornieieva 
1   American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten
,
Paul Kelly
1   American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten
,
Daniel Lee
1   American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten
,
Azmy Hadidy
2   Diagnostic Radiology and Nuclear Medicine, The University of Jordan, Amman, Jordan
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Introduction The wide range of anatomical variability of the structures of the middle cranial fossa (MCF) and the lack of reliable surgical landmarks contribute to a high level of complications in the surgical treatment of vestibular schwannomas. We hypothesized that the cranial phenotype influences the shape of the MCF, the orientation of the pyramid of the temporal bone, and the relative topography of the internal acoustic canal (IAC).

Methods The skull base structures were studied on 54 embalmed cadavers and 60 magnetic resonance images of the head and neck by photo modeling, dissection, and three-dimensional analysis techniques. By the value of the cranial index, all specimens were subdivided into dolichocephalic, mesocephalic, and brachycephalic groups for comparison of variables.

Results The length of the superior border of the temporal pyramid (SB), the apex to squama distance, and the width of the MCF all peaked in the brachycephalic group. The value of the angle between the SB and the axis of the acoustic canal varied from 33 to 58 degrees; it peaked in the dolichocephalic group and showed its smaller value in the brachycephalic one. The pyramid to squama angle had reversed distribution and dominated in the brachycephalic group.

Conclusion The cranial phenotype influences the shape of the MCF, temporal pyramid, and IAC. Presented in this article data help specialists operating on the vestibular schwannoma to localize the IAC based on the individual shape of a skull.

Keywords

cranial index - anatomical variability - internal acoustic canal - temporal bone - middle cranial fossa - vestibular schwannoma


Publication History

Received: 29 June 2021

Accepted: 28 January 2022

Article published online:
09 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Myrseth E, Pedersen PH, Møller P, Lund-Johansen M. Treatment of vestibular schwannomas. Why, when and how?. Acta Neurochir (Wien) 2007; 149 (07) 647-660 , discussion 660
    CrossrefPubMedGoogle Scholar
  • 2 Gonzalez F, Ferreira M, Zabramski J, Spetzler R, Deshmukh P. The middle fossa approach. Barrow Quarterly 2000; 16 (04) 67-85
    PubMedGoogle Scholar
  • 3 Staecker H, Nadol Jr JB, Ojeman R, Ronner S, McKenna MJ. Hearing preservation in acoustic neuroma surgery: middle fossa versus retrosigmoid approach. Am J Otol 2000; 21 (03) 399-404
    CrossrefPubMedGoogle Scholar
  • 4 Farahani R, Nooranipour M, Nikakhtar K. Anthropometry of internal acoustic meatus. Int J Morphol 2007; 5 (04) 861-865
    PubMedGoogle Scholar
  • 5 Faure A, Masse H, Gayet-Delacroix M. et al. What is the arcuate eminence?. Surg Radiol Anat 2003; 25 (02) 99-104
    CrossrefPubMedGoogle Scholar
  • 6 Maina R, Ducati A, Lanzino G. The middle cranial fossa: morphometric study and surgical considerations. Skull Base 2007; 17 (06) 395-403
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Peris-Celda M, Perry A, Carlstrom LP, Graffeo CS, Driscoll CLW, Link MJ. Key anatomical landmarks for middle fossa surgery: a surgical anatomy study. J Neurosurg 2018; 131: 1-10
    CrossrefPubMedGoogle Scholar
  • 8 Wigand ME, Haid T, Berg M. The enlarged middle cranial fossa approach for surgery of the temporal bone and of the cerebellopontine angle. Arch Otorhinolaryngol 1989; 246 (05) 299-302
    CrossrefPubMedGoogle Scholar
  • 9 Mahboubi H, Ahmed OH, Yau AY, Ahmed YC, Djalilian HR. Complications of surgery for sporadic vestibular schwannoma. Otolaryngol Head Neck Surg 2014; 150 (02) 275-281
    CrossrefPubMedGoogle Scholar
  • 10 Betka J, Zvěřina E, Balogová Z. et al. Complications of microsurgery of vestibular schwannoma. BioMed Res Int 2014; 2014: 315952
    CrossrefPubMedGoogle Scholar
  • 11 Kavitha L, Karthik K. Comparison of cephalometric norms of Caucasians and non-Caucasians: a forensic aid in ethnic determination. J Forensic Dent Sci 2012; 4 (01) 53-55
    PubMedGoogle Scholar
  • 12 Mesejo P, Marto R, Ibáñez Ó, Novo J, Ortega M. A survey on artificial intelligence techniques for biomedical image analysis in skeleton-based forensic human identification. Appl Sci (Basel) 2020; 10 (14) 4703
    CrossrefPubMedGoogle Scholar
  • 13 Chin A, Perry S, Liao C, Yang Y. The relationship between the cranial base and jaw base in a Chinese population. Head Face Med 2014; 10: 31
    CrossrefPubMedGoogle Scholar
  • 14 Kornieieva M, Hadidy A, Zhuravlova I. Variability of the middle meningeal artery subject to the shape of skull. J Neurol Surg B Skull Base 2015; 76 (06) 451-458
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Kornieieva M, Zhuravlova I, Hadidy A. Stereotactic characteristics of the thalamus subject to shape of the skull: an MRI study. Open Acc Res Anatomy 2017; 1 (01) 504
    PubMedGoogle Scholar
  • 16 Meneses MS, Moreira AL, Bordignon KC, Pedrozo AA, Ramina R, Nikoski JG. Surgical approaches to the petrous apex: distances and relations with cranial morphology. Skull Base 2004; 14 (01) 9-19 , discussion 19–20
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Senol R, Safak N, Yucel A. Anthropometric evaluation of cranial indexes. International Journal of Contemporary Medical Research 2019; 6 (10) 1-4
    PubMedGoogle Scholar
  • 18 Morrison AW, King TT. Experiences with a translabyrinthine-transtentorial approach to the cerebellopontine angle. Technical note. J Neurosurg 1973; 38 (03) 382-390
    CrossrefPubMedGoogle Scholar
  • 19 Allanson JE, Cunniff C, Hoyme HE, McGaughran J, Muenke M, Neri G. Elements of morphology: standard terminology for the head and face. Am J Med Genet A 2009; 149A (01) 6-28
    CrossrefPubMedGoogle Scholar
  • 20 Rosahl S, Eßer D. Chirurgische Techniken zur Behandlung des Vestibularisschwannoms. HNO 2017; 65 (05) 395-403
    CrossrefPubMedGoogle Scholar
  • 21 Garcia-Ibanez E, Garcia-Ibanez JL. Middle fossa vestibular neurectomy: a report of 373 cases. Otolaryngol Head Neck Surg 1980; 88 (04) 486-490
    CrossrefPubMedGoogle Scholar
  • 22 Hovelacque A. Oste'ologie II, Cra^ ne-Face. Paris: Douin; 1934: 65-74
    Google Scholar
  • 23 Paturet G. Traite' d'anatomie humaine. Paris: Masson; 1951: 130
    Google Scholar
  • 24 Schick B, Dlugaiczyk J. Surgery of the ear and the lateral skull base: pitfalls and complications. GMS Curr Top Otorhinolaryngol Head Neck Surg 2013; 12: Doc05
    PubMedGoogle Scholar