Microsurgical endoscopy-assisted presigmoid retrolabyrinthine approach with mastoid bone drilling: an anatomical laboratory investigation

• Published in: Surgical and radiologic anatomy (English ed.) 2022-03, Vol.44 (3), p.369-380
• Main Authors: Turkis, Omer Furkan, Senoglu, Mehmet, Karadag, Ali, Guvencer, Mustafa, Karabay, Nuri, Bayramli, Nijat, Sayhan, Salih, Tanriover, Necmettin
• Format: Article
• Language: English
• Subjects: Anatomy; Cadavers; Computed tomography; Endoscopes; Endoscopy; Endoscopy - methods; Endoscopy, Gastrointestinal; Humans; Imaging; Laboratories; Mastoid - diagnostic imaging; Mastoid - surgery; Medicine; Medicine & Public Health; Microsurgery - methods; Neurosurgical Procedures - methods; Original Article; Orthopedics; Radiology; Surgery
• ISSN: 1279-8517; 0930-1038; 1279-8517
• DOI: 10.1007/s00276-021-02869-5

Purpose This study aims to evaluate the applicability of the endoscopy-assisted presigmoid retrolabyrinthine approach, advantages, disadvantages, and the applicability of surgery with pre-op radiological parameters; identify important landmarks; and to reveal their relationships with important structures in the surgical field with objective data. Also, we aim to improve the surgical technique for increasing reachable anatomic structure. Methods Mastoid drilling and endoscopy-assisted presigmoid retrolabyrinthine approach were performed and endoscopic instruments were used to obtain the three-dimensional pictures. Computed tomography images were evaluated to correlate to the anatomic data. Results In terms of pre-operative radiological evaluation of the applicability of the presigmoid approach were investigated with selected radiological parameters. The endoscopy-assisted presigmoid retrolabyrinthine approach applied to cadavers the relationship, distances between important anatomical landmarks, and anatomical structures in the surgical field recorded. The anatomical structures that could reach with the application of the procedure were recorded. The relationship between pre-operative measured radiological parameters and surgical results was evaluated with objective data. Additional combinations to improve this surgical method discussed and the results of our combination were recorded with photographs. Conclusion Although the presigmoid retrolabyrinthine approach has facilitated with the assistance of endoscope, it has observed that there are still some difficulties, and it has been concluded that the radiological parameters are useful in evaluating the applicability of this surgery. It observed that this surgery can be performed more effectively with combinations.