ABSTRACT
OBJECTIVE: The objective is to describe the relationship of anatomical landmark required for the middle fossa approach to preservation of hearing. METHODS: Dissection of 16 fixed human cadaveric heads was performed. we identified a rhomboid-shaped middle fossa landmarks that serve as a guide to minimize cochlea injury. The points of this construct are as follows ; 1) the junction of the greater superficial petrosal nerve and the trigeminal nerve ; 2) the lateral edge of the porus trigemius ; 3) the intersection of the petrous ridge and arcuate eminence ; and 4) the intersection of the lines extended along the axes of the greater superficial petrosal nerve and arcuate eminence. Mean, minimum, and maximum measurements of all distances were determined. RESULTS: The average cochlea-geniculate ganglion distance measured in the dissected specimens was 3.0+/-0.8mm with a range of 1.2 to 4.1mm. The average cochlea-petrous carotid genu distance was 2.9+/-0.9mm with a range of 1.2 to 4.0mm. The average cochlea-internal acoustic meatus distance measured in the dissected specimens was 9.0+/-0.5mm with a range of 7.8-10.9mm. The average cochlea-mandibular nerve distance measured was 9.4+/-0.4mm with a range of 7.6-11.3mm. CONCLUSION: The middle fossa approach requires special knowledge of the anantomy to reduce the risk of damage to cochlea. It is important that the surgeon understand the surgical anantomy. The present study describes the simple geometric construct that proposes to assist in locating the cochlea.
Subject(s)
Humans , Acoustics , Cadaver , Cochlea , Ganglion Cysts , Head , Hearing , Trigeminal NerveABSTRACT
Recently anterior spinal device in the treatment of the unstable thoraco-lumbar spine has been used. We have experienced 11 patients of the unstable thoraco-lumbar spine, which were composed of 8 patients with burst fracture and 3 patients with tuberculous spondylitis. The 11 patients with neurological deficit were treated with an one stage anterior operation consisting of anterior decompression through vertebrectomy, realignment with Kanedae device. No patient showed neurologic deterioration after surgery. The anterior spinal instrumentation with Kaneda device afford enough stability to enable early ambulation with good alignment and solid fusion.
Subject(s)
Humans , Decompression , Early Ambulation , Spine , SpondylitisABSTRACT
Fourteen consecutive patients underwent application of V.S.P(Variable Screw Placement) spinal plate between January 1989 and July 1989. Operative indications were spondylolisthesis, spinal stenosis, segmental instability, herniated disc with instability, pseudoarthrosis. unstable fracture, and failed surgery syndrome. Our patients consist of 8 cases of spondylolisthesis, 4 cases of fracture-dislocation, one case of spondylolysis with instability, one case of herniated disc(L1- 2 interspace). Overall results showed 36% excellent, 50% good, 7% fair, 7% poor. Two deep wound infections were observed. Screw alignment and the angular relationship of each screw to the spinal plate is considered as important technical factors in minimizing screw failure.