External Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study

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dc.authorscopusidAbuzer Güngör / 54895233300
dc.authorwosidAbuzer Güngör / F-4189-2019
dc.contributor.authorŞahin, Mustafa
dc.contributor.authorGüngör, Abuzer
dc.contributor.authorDoǧruel, Yücel
dc.contributor.authorLuzzi, Sabino
dc.contributor.authorYılmaz, Adem
dc.contributor.authorTüre, Uğur
dc.date.accessioned2025-04-18T10:31:14Z
dc.date.available2025-04-18T10:31:14Z
dc.date.issued2025
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.description.abstractBACKGROUND AND OBJECTIVES: The middle fossa approaches are tremendously versatile for treating small vestibular schwannomas, selected petroclival meningiomas, midbasilar trunk aneurysms, and lesions of the petrous bone. Our aim was to localize the internal acoustic canal and safely drill the petrous apex with these approaches. This study demonstrates a new method to locate the internal acoustic canal during surgery in the middle fossa. METHODS: The microsurgical anatomy of the middle fossa floor was studied in 11 formalin-fixed and silicone-injected cadaveric heads. Extradural dissection of the skull base was completed from the posterior to the anterior side. A zero-degree rigid endoscope was inserted perpendicularly into the external auditory canal. The light beam was first directed through the tympanic membrane, avoiding injury to the tympanic membrane. The room lights were dimmed to provide a clearer view of the transilluminated bony area. Drilling was performed with transillumination guidance. RESULTS: The transilluminated area included the tympanic and mastoid tegmen up to the arcuate eminence. The nonilluminated area was bounded posteriorly by the arcuate eminence, laterally by the greater superficial petrosal nerve, and posteromedially by the petrous ridge. In all specimens, drilling the transition line between the Kawase triangle and the transilluminated area unroofed the internal auditory canal (IAC). No transillumination of the carotid canal was seen after anterior petrosectomy in any of the specimens. The entire contents of the IAC were preserved in both anterior petrosectomy and unroofing of the IAC. CONCLUSION: In this anatomical study, transillumination of the external auditory canal proved to be feasible, accurate, and safe in guiding the middle fossa approaches. The ease of implementation and cost-effectiveness of the technique may suggest a possible application in operative scenarios. © Congress of Neurological Surgeons 2025. All rights reserved.
dc.identifier.citationŞahin, M., Güngör, A., Doğruel, Y., Luzzi, S., Yilmaz, A., & Türe, U. (2022). External Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study. Operative Neurosurgery, 10-1227.
dc.identifier.doi10.1227/ons.0000000000001492
dc.identifier.issn23324252
dc.identifier.pmid39774128
dc.identifier.scopus2-s2.0-85215326978
dc.identifier.scopusqualityQ2
dc.identifier.urihttp://dx.doi.org/10.1227/ons.0000000000001492
dc.identifier.urihttps://hdl.handle.net/20.500.12713/7100
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGüngör, Abuzer
dc.institutionauthoridAbuzer Güngör / 0000-0002-2792-7610
dc.language.isoen
dc.publisherLippincott Williams and Wilkins
dc.relation.ispartofOperative Neurosurgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAnterior Petrosectomy
dc.subjectInternal Auditory Canal
dc.subjectKawase Triangle
dc.subjectMiddle Fossa Approach
dc.subjectSkull Base Surgery
dc.subjectTransillumination
dc.subjectVestibular Schwannomas
dc.titleExternal Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study
dc.typeArticle

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