Document Detail


Percutaneous access to the petrous apex in vitro using customized micro-stereotactic frames based on image-guided surgical technology.
MedLine Citation:
PMID:  19707904     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Conclusion. Our study demonstrates (in cadavers) the ability to obtain a minimally invasive approach to access the petrous apex using patient-customized micro-stereotactic frames based on pre-intervention radiographic studies. Objective. To conduct in vitro studies to demonstrate the feasibility of percutaneous petrous apex access using customized, bone-mounted, micro-stereotactic frames. Methods. Cadaveric temporal bone specimens (n=10) were affixed with three bone-implanted fiducial markers. CT scans were obtained and used in planning, in reference to the fiducial markers, a straight transmastoid infralabyrinthine trajectory from the mastoid surface to the petrous apex without violating the basal turn of the cochlea or the carotid artery. A drill press was mounted on the customized frame and used to guide a 2 mm drill bit on the desired trajectory. The course of the drill bit and its relationship to surrounding vital anatomy (cochlea, carotid artery, facial nerve, and internal jugular vein) were determined by repeat CT scanning. Results. In 10 of 10 specimens, the drill bit trajectory was accurate with clearance (mean+/-standard deviation in mm) from the cochlea, facial nerve, carotid artery, and jugular vein of 3.43+/-1.57, 3.14+/-1.15, 4.57+/-1.52, and 6.05+/-2.98, respectively.
Authors:
George B Wanna; Ramya Balachandran; Omid Majdani; Jason Mitchell; Robert F Labadie
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-8-25
Journal Detail:
Title:  Acta oto-laryngologica     Volume:  -     ISSN:  1651-2251     ISO Abbreviation:  Acta Otolaryngol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-8-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370354     Medline TA:  Acta Otolaryngol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-6     Citation Subset:  -    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
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