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2 results

  • Surgical anatomy of the anterior supralabyrinthine air cell tract

  • M B Gluth, M A Cohen, P L Friedland, M D Atlas
  • Journal:
    The Journal of Laryngology & Otology / Volume 125 / Issue 10 / October 2011
    Published online by Cambridge University Press:
    14 June 2011, pp. 1009-1013
    Print publication:
    October 2011
  • Introduction:

    In order to safely explore the medial wall of the attic, a working knowledge of the anatomy of the anterior supralabyrinthine air cell tract is required.

    Aim:

    To clarify the surgically relevant anatomical relationships that comprise the anterior supralabyrinthine air cell tract.

    Materials and methods:

    Surgical dissection of 10 fresh cadaveric temporal bones was undertaken, including measurement of distances between the key anterior supralabyrinthine anatomical landmarks.

    Results:

    The following mean distances were calculated: the labyrinthine segment between the geniculate ganglion and the ampullated end of the superior semicircular canal, 2.33 mm (range 1.75–2.75); the tympanic segment between the anterior margin of the oval window niche and the geniculate ganglion, 3.58 mm (range 3.25–4); and from the tympanic segment adjacent to the anterior margin of the oval window niche to the labyrinthine segment adjacent to the superior semicircular canal, 3.48 mm (range 3–4.25).

    Conclusion:

    The key anatomical landmarks of the anterior supralabyrinthine air cell tract define a distinct triangular segment of bone, knowledge of which is helpful in surgical dissection.

  • Primary brain stem tethering: a rare cause of geniculate neuralgia

  • Geert G. Buyse, Jo Caekebeke, Philippe Demaerel, Chris Plets
  • Journal:
    The Journal of Laryngology & Otology / Volume 113 / Issue 10 / October 1999
    Published online by Cambridge University Press:
    29 June 2007, pp. 945-947
    Print publication:
    October 1999

  • This rare case of brain stem tethering presented with chronic and progressive geniculate neuralgia. In view of the fact that an occipital subcutaneous lipoma had been resected in childhood, it probably concerned a primary tethering, fitting in with an occult occipital dysraphism.

    Magnetic resonance imaging (MRI) clearly demonstrated an underlying tethering, causing a distortion of the brain stem. Consequently, this led to the hypothesis that the geniculate neuralgia could be explained by traction on the lower cranial nerves secondary to the brain stem displacement. Untethering resulted in a considerable decrease of the neuralgia.

    MRI proved to be essential in the diagnosis and treatment of this unusual case.