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J Anat. 2019 Mar;234(3):316-326. doi: 10.1111/joa.12926. Epub 2018 Dec 18.

Three-dimensional imaging of the human internal acoustic canal and arachnoid cistern: a synchrotron study with clinical implications.

Author information

1
Department of Surgical Sciences, Section of Otolaryngology, Uppsala University Hospital, Uppsala, Sweden.
2
Department of Otolaryngology, Peking University Shenzhen Hospital, Shenzhen, China.
3
Department of Otolaryngology-Head and Neck Surgery, Department of Medical Biophysics, Department of Electrical and Computer Engineering, Western University, London, ON, Canada.
4
Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
5
Department of Neurosurgery and Outpatient Clinic Klinikum Fulda, Academic Hospital of University of Marburg, Marburg, Germany.

Abstract

A thorough knowledge of the gross and micro-anatomy of the human internal acoustic canal (IAC) is essential in vestibular schwannoma removal, cochlear implantation (CI) surgery, vestibular nerve section, and decompression procedures. Here, we analyzed the acoustic-facial cistern of the human IAC, including nerves and anastomoses using synchrotron phase contrast imaging (SR-PCI). A total of 26 fresh human temporal bones underwent SR-PCI. Data were processed using volume-rendering software to create three-dimensional (3D) reconstructions allowing soft tissue analyses, orthogonal sectioning, and cropping. A scalar opacity mapping tool was used to enhance tissue surface borders, and anatomical structures were color-labeled for improved 3D comprehension of the soft tissues. SR-PCI reproduced, for the first time, the variable 3D anatomy of the human IAC, including cranial nerve complexes, anastomoses, and arachnoid membrane invagination (acoustic-facial cistern; an extension of the cerebellopontine cistern) in unprocessed, un-decalcified specimens. An unrecognized system of arachnoid pillars and trabeculae was found to extend between the arachnoid and cranial nerves. We confirmed earlier findings that intra-meatal vestibular schwannoma may grow unseparated from adjacent nerves without duplication of the arachnoid layers. The arachnoid pillars may support and stabilize cranial nerves in the IAC and could also play a role in local fluid hydrodynamics.

KEYWORDS:

Uppsala collection; human; micro-computerized tomography; synchrotron phase contrast imaging; temporal bone

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