Revisit to the Accuracy of Arcuate eminence as a Surgical landmark for Superior semicircular canal in Middle cranial fossa surgeries
Keywords:
Arcuate eminence, Superior semicircular canal, Middle cranial fossa surgery, Temporal bone dissection, Anatomical landmarks, Skull base surgery, Otologic surgery, Neurotologic procedures, Surgical anatomy, Anatomical variabilityAbstract
Introduction-
The arcuate eminence is a well-recognized anatomical landmark on the petrous part of the temporal bone and has historically been used as a reference point for identifying the superior semicircular canal. Precise localization of the superior semicircular canal is critical in otologic and neurotologic surgeries. It is used in surgery of the middle cranial fossa as a reference point to locate the internal acoustic canal within the temporal bone. This study aims to evaluate the anatomical precision of the arcuate eminence as a surface landmark for the superior semicircular canal, with a distinct focus on determining the part of the canal that is exposed.
Materials and methods –
A cross sectional study was done on 20 dry temporal bones from February 2025 till April 2025. The bones were dissected in the Temporal bone dissection lab of department of Otorhinolaryngology & Head and Neck surgery, R L Jalappa Hospital, Tamaka, Kolar. The arcuate eminence in these specimens is recognized as a small, raised ridge or rounded elevation located near the midpoint of the petrous part of the temporal bone. Meticulously drilling Over the Arcuate Eminence to gradually thin the bone,the ivory coloured bony outline of the SSC start to appear. The canal will appear as a curved, hollow structure within the petrous bone. The angle formed between the long axis of the arcuate eminence and the tangential line connecting the petrous apex to the superior petrosal sinus will be analysed.
Additionally, the distance from the arcuate eminence to the inner part of squamous part of temporal bone also analysed. These are measured with the help of a divider, protractor and ruler.
Results-
Doom of superior semi circular canal was corresponding to arcuate eminence in 11 specimens (55%) and not corresponding to arcuate eminence in 9 specimens (45%).
The angle between the arcuate eminence and the superior petrosal sulcus varied among specimens, with a mean angle of
37.65°.
The distance between the arcuate eminence and the inner squamous part of the temporal bone showed variability, with a mean distance of 19.9 mm
Conclusion-
The current study reaffirms that while the arcuate eminence is often used as a superficial landmark for locating the superior semicircular canal during middle cranial fossa surgeries, its accuracy as a reliable and consistent guide is limited..
Downloads
Metrics
References
Seo Y, Ito T, Sasaki T, Nakagawara J, Nakamura H. Assessment of the anatomical relationship between the arcuate eminence and superior semicircular canal by computed tomography. Neurol Med Chir (Tokyo). 2007;47(8):335–340.
Fisch U. Transtemporal surgery of the internal auditory canal. Report of 92 cases, technique, indications and results. Adv Otorhinolaryngol. 1970; 17:203-240.
Rhoton AL. Anatomy and surgical approaches of the temporal bone and adjacent areas. Neurosur- gery. 2007;61:1-250.
García-Barrios A, Cisneros AI, Obon J, Crovetto R, Benito J, Whyte J. Anatomical study between the correlation of the arcuate eminence and the superior semicircular canal. Surg Radiol Anat. 2021;43(12):1845-1850.
Preet K, Udawatta M, Mozaffari K, Ong V, Franks A, Ng E, Gaonkar B, Sun MZ, Salamon N, Gopen Q, Yang I. Relationship between superior semicircular canal dehiscence volume with clinical symptoms: Case series. World Neurosurg. 2021 Dec;156:e345–e350.
Peris-Celda M, Perry A, Carlstrom LP, Graffeo CS, Driscoll CLW, Link MJ. Key anatomical landmarks for middle fossa surgery: a surgical anatomy study. J Neurosurg. 2018:1-10.
Singh A, Kumar R, Irugu DVK, Kumar R, Sagar P. Morphometric analysis of arcuate eminence: A distinctive landmark for middle cranial fossa approach. J Craniomaxillofac Surg. 2018.
Rao MP, Balasubramanyam V. Arcuate eminence: Is it due to semicircular canal? Indian J Otol. 2012;18(1):15-19.
Niesten MEF, Lookabaugh S, Curtin H, et al. Familial Superior Canal Dehiscence Syndrome. JAMA Otolaryngol Head Neck Surg. 2014;140(4):363–368.
Díaz MP, Cisneros JC, Alarcón AV. Superior semicircular canal dehiscence syndrome: diagnosis and surgical management. Int Arch Otorhinolaryngol. 2017;21(2):195–198.
Tsutsumi S, Ono H, Ishii H. The arcuate eminence and superior semicircular canal: magnetic resonance imaging study. J Comput Assist Tomogr. 2021 Sep-Oct;45(5):749–752.
Santos FP, Longo MG, May GG, Isolan GR. Computed tomography evaluation of the correspondence between the arcuate eminence and the superior semicircular canal. World Neurosurg. 2018 Mar;111:e261–e266...
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.