Abstract:
Objective This study was aimed to better characterize the surgical anatomy of the floor of the middle cranial fossa using three dimensional Euclidean relationships between the arcuate eminence (AE), the superior semicircular canal (SSC), and the geniculate ganglion (GG). Study Design Submillimeter distances were recorded from computed tomography (CT) scans of 50 patients (100 sides). The AE, apex of the SSC, and the GG were identified and three dimensional distances measured. Setting The study was conducted at a tertiary academic teaching hospital. Main Outcome Measures In this study, Euclidean distance was obtained from AE to SSC by using a fixed anatomical landmark (GG) as the origin. Results On average, the AE is 2.1 ± 0.3 mm lateral, 2.5 ± 0.1 mm superior, and 2.1 ± 0.3 posterior to the SSC. Thirty percent (30/100) of patients had an AE that was less than 2 mm superior to SSC. The AE was medial to the SCC in 13% samples and anterior to the SSC in 18% samples. The results also show that there was no difference in mean distance between sides (1.08 mm; 95% confidence interval [CI] = - 2.67-0.52; p -value = 0.29) or gender (0.56 mm; 95% CI = - 1.34, 2.45; p -value = 0.86). Conclusions This study represents a comprehensive analysis of the relational anatomy of the floor of the middle fossa to date. In quantifying relationships between the AE, SSC, and GG, and by understanding the variability of these relationships in some planes, the middle fossa surgeon can feel more comfortable with this most challenging approach.
摘要:
目的本研究旨在利用弓状隆起(AE)之间的三维欧氏关系更好地表征中颅窝底部的手术解剖,上半规管(SSC),和膝状神经节(GG)。研究设计从50名患者(100侧)的计算机断层扫描(CT)扫描记录亚毫米距离。TheAE,SSC的顶点,识别GG并测量三维距离。设置该研究是在三级学术教学医院进行的。本研究的主要结果指标,通过使用固定的解剖标志(GG)作为原点,从AE到SSC获得欧几里得距离。结果平均而言,AE横向为2.1±0.3mm,优于2.5±0.1mm,和SSC后面的2.1±0.3。30%(30/100)的患者的AE小于2mm,优于SSC。AE在13%样品中位于SCC中间,在18%样品中位于SSC之前。结果还表明,两侧之间的平均距离(1.08mm;95%置信区间[CI]=-2.67-0.52;p值=0.29)或性别(0.56mm;95%CI=-1.34,2.45;p值=0.86)没有差异。结论本研究是对迄今为止中窝底部关系解剖的全面分析。在量化AE之间的关系时,SSC,GG,通过理解这些关系在某些平面上的可变性,对于这种最具挑战性的方法,中窝外科医生会感到更舒服。