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Comparative evaluation of round window niche accessibility pre-operatively on high-resolution computed tomography of the temporal bone with intra-operative findings

Published online by Cambridge University Press:  28 June 2019

R Sharma ,
R Meher ,
J C Passey ,
J Kumar ,
A Gupta  and
S Kharbanda
R Sharma*
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
R Meher
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
J C Passey
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
J Kumar
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
A Gupta
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
S Kharbanda
Affiliation:
Department of Otorhinolaryngology, Lok Nayak Hospital, New Delhi, India
*
Author for correspondence: Dr Raman Sharma, Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India 110002 E-mail: raman.96sharma@gmail.com
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Abstract

Objective

To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.

Methods

Nineteen patients scheduled for cochlear implantation, aged 2–20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings.

Results

The mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16–69.37°), 63.81° (58.61–71.35°) and 56.48° (50.37–59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016).

Conclusion

Pre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.

Keywords

Round WindowEarCochlear ImplantsEndoscopyFacial Recess ApproachComputed TomographyX-RayTemporal Bone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 575 - 579
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr R Sharma takes responsibility for the integrity of the content of the paper

References

1Jeffery, N, Spoor, F. Prenatal growth and development of the modern human labyrinth. J Anat 2004;204:71–92Google Scholar
2Li, PM, Wang, H, Northrop, C. Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol 2007;28:641–8Google Scholar
3Pendem, SK, Rangasami, R, Arunachalam, RK. HRCT correlation with round window identification during cochlear implantation in children. J Clin Imaging Sci 2014;4:70Google Scholar
4Leong, AC, Jiang, D. Evaluation of round window accessibility to cochlear implant insertion. Eur Arch Otorhinolaryngol 2013;270:1237–42Google Scholar
5Karatas, E, Aud, MD, Baglam, T. Intraoperative electrically evoked stapedius reflex thresholds in children undergone cochlear implantation: round window and cochleostomy approaches. Int J Pediatr Otorhinolaryngol 2011;75:1123–6Google Scholar
6Roland, PS, Wright, CG, Isaacson, B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope 2007;117:1397–402Google Scholar
7Francis, HW, Niparko, JK. Cochlear implantation update. Pediatr Clin North Am 2003;50:341–61Google Scholar
8Takahashi, H, Sando, I. Computer-aided 3-D temporal bone anatomy for cochlear implant surgery. Laryngoscope 1990;100:417–21Google Scholar
9Shapira, Y, Eshraghi, AA, Balkany, TJ. The perceived angle of the round window affects electrode insertion trauma in round window insertion – an anatomical study. Acta Otolaryngol 2011;131:284–9Google Scholar
10Pau, HW, Just, T. Noise exposure of the inner ear during drilling a cochleostomy for cochlear implantation. Laryngoscope 2007;117:535–40Google Scholar
11Briggs, RJ, Tycocinski, M, Stidham, K. Cochleostomy site: implications for electrode placement and hearing preservation. Acta Otolaryngol 2005;125:870–6Google Scholar
12Paprocki, A, Biskup, B, Kozłowska, K. The topographical anatomy of round window and related structures for the purpose of cochlear implant surgery. Folia Morphol (Warsz) 2004;63:309–12Google Scholar
13Lloyd, SK, Kasbekar, AV, Kenway, B. Developmental changes in cochlear orientation – implications for cochlear implantation. Otol Neurotol 2010;31:902–7Google Scholar
14Chen, K, Lyu, H, Xie, Y, Yang, L, Zhang, T, Dai, P. Morphological characteristics of round window niche in congenital aural atresia and stenosis patients. J Comput Assist Tomogr 2015;39:547–51Google Scholar
15Bettman, RH, Appelman, AM, van Olphen, AF. Cochlear orientation and dimensions of the facial recess in cochlear implantation. J Otorhinolaryngol Relat Spec 2003;65:353–8Google Scholar
16Adunka, O, Unkelbach, MH, Mack, M. Cochlear implantation via the round window membrane minimizes trauma to cochlear structures: a histologically controlled insertion study. Acta Otolaryngol 2004;124:807–12Google Scholar