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Using the processus cochleariformis as a multipurpose landmark in middle cranial fossa surgery

Published online by Cambridge University Press:  20 May 2008

T Ulug
T Ulug*
Affiliation:
ENT Department, Istanbul Medical Faculty, Istanbul University, Turkey
*
Address for correspondence: Prof Tuncay Ulug, ENT Department, Istanbul Medical Faculty, Istanbul University, Capa, Istanbul, Turkey. E-mail: ulugt@ttmail.com
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Abstract

Objective:

To demonstrate that the anatomical structure known as the processus cochleariformis, with its intimate and constant relationships to inner-ear structures, can be used as a reliable landmark during middle cranial fossa surgery, alone or in conjunction with other landmarks.

Study design:

An anatomical study using cadaveric temporal bones to define six reproducible measurements that relate the processus cochleariformis to inner-ear structures, and to define 14 other measurements that relate inner-ear structures to adjacent structures within the intact bone.

Method:

Using 10 cadaver specimens, 20 reproducible measurements were defined. The first six of these defined the relation of the processus cochleariformis to inner-ear structures in the middle cranial fossa approach. The other measurements defined the exact location of the inner-ear structures and adjacent structures within the intact bone.

Results:

The vertical crest lies at a 20° angle from the processus cochleariformis to the coronal plane, and at a distance of 5 to 6 mm from the processus cochleariformis. The point at which the medial margin of the basal turn of the cochlea crosses the labyrinthine segment of the facial nerve lies at a 0° angle from the processus cochleariformis to the coronal plane, and at a distance of 6.5 to 7.5 mm from the processus cochleariformis. The superior semicircular canal lies at a 45° angle from the processus cochleariformis to the coronal plane. The other measurements obtained give important clues about the position of the cochlea, vestibulum, greater superficial petrosal nerve and labyrinthine segment of the facial nerve.

Conclusions:

If the classical landmarks are indiscernible during middle cranial fossa surgery, then the processus cochleariformis, with its intimate and constant relationships to inner-ear structures, is a safe and constant landmark.

Keywords

Facial NerveProcessus CochleariformisMiddle Cranial FossaOtologic Surgical Procedures

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 2 , February 2009 , pp. 163 - 169
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented in part at the Otology 2000 Achievements and Perspectives XXII Annual Meeting of the Politzer Society, 15–19 August 1999, Zürich, Switzerland, and at International Istanbul Otorhinolaryngology Meeting-2003, 9–11 May, 2003, Istanbul, Turkey.

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