title: Inferior mastoidectomy-hypotympanic approach for surgical removal of glomus jugulare tumors: an anatomical and radiologic study emphasizing distances between critical structures.
abstract: The technique of inferior mastoidectomy-hypotympanic dissection, with preservation of the middle and inner ear structures, has been established for radical surgical removal of glomus tumors involving the skull base. In order to study the gross anatomic differences and correlate with the computed tomography (CT) scan, 20 human temporal bones were dissected and accurate measurements between vital structures were made. This study revealed a wide variation in distances between the neurovascular structures, whereas the distances between inner ear structures were not statistically different. This original study of critical distances of gross topographic anatomical structures and CT correlation is very helpful indeed in the understanding of variations found in the surgical removal of lesions involving this important and challenging area of the skull base. The inferior mastoidectomy-hypotympanic dissection has been performed in the removal of six suitable tumors involving the jugular bulb area. This technique, combined with upper cervical dissection, is very useful for the radical removal of such neoplasms with preservation of external and middle ear structures as well as the function of the facial, eighth, and other lower cranial nerves.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: A J
authors.initials: AJ
authors.lastname: Maniglia
authors.forename: R C
authors.initials: RC
authors.lastname: Sprecher
authors.forename: C A
authors.initials: CA
authors.lastname: Megerian
authors.forename: C
authors.initials: C
authors.lastname: Lanzieri
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003051:Cochlea / Q000000981:diagnostic imaging / Q000473:pathology; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000473:pathology; D004210:Dissection; D004424:Ear Canal / Q000000981:diagnostic imaging / Q000473:pathology; D004432:Ear, Middle / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005154:Facial Nerve / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005924:Glomus Jugulare / Q000000981:diagnostic imaging / Q000473:pathology; D005925:Glomus Jugulare Tumor / Q000601:surgery*; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging / Q000473:pathology; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D012405:Round Window, Ear / Q000000981:diagnostic imaging / Q000473:pathology; D012665:Semicircular Canals / Q000000981:diagnostic imaging / Q000473:pathology; D013199:Stapes / Q000000981:diagnostic imaging / Q000473:pathology; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed