A Detailed Topographic Neurovascular Anatomy for Vestibular Neurosurgery

Abstract

Objective:The posterior cranial fossa and the cerebello-pontine angle, with their complex structures, require an understanding of detailed anatomy. In this study it is aimed to examine the superior petrosal vein, fissure veins, choroid plexus, superior cerebellar, anterior inferior cerebellar, posterior inferior cerebellar, vertebral, and labyrinthine arteries in vivo for their connections to the cranial nerves (intermediate, abducent, facial, and vestibulocochlear nerves) of the middle neurovascular complex. Methods:The operation records of the 109 patients were evaluated to clarify the topographic interaction in the posterior cranial fossa. Meanwhile, the percentage of uncommon relations among the neurovascular structures in the middle complex area was evaluated. Results:The vestibulocochlear nerve's topographic relationships were studied in connection with the surrounding neurovascular structures. Out of 109 cases, the superior petrosal vein was seen in 39, the superior cerebellar artery in 14, the anterior inferior cerebellar artery in 66, and the labyrinthine artery in 22. Patients with facial and vestibulocochlear nerves were found in all cases. Intermediate and abducent nerves were found in 8 and 14 cases respectively. Conclusions:It's crucial to comprehend and pay attention to anatomical variations during vestibular neurectomy. Our results, based on live surgical observations, may be beneficial in planning surgical approaches.