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Cochlear orientation: pre-operative evaluation and intra-operative significance

Published online by Cambridge University Press:  18 July 2018

S Sharma
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
M Grover*
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
S N Singh
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
T Kataria
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
R S Lakhawat
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
*
Address for correspondence: Dr Mohnish Grover, Department of Otorhinolaryngology and Head Neck Surgery, SMS Medical College and Hospital, Jaipur – 302004, Rajasthan, India E-mail: drmohnish_aiims@rediffmail.com

Abstract

Objective

The study primarily aimed to calculate the orientation of the cochlea pre-operatively, using high-resolution computed tomography of the temporal bone, and predict the ease of electrode insertion.

Methods

Pre-operatively, high-resolution computed tomography scans were conducted on children scheduled for cochlear implantation, and two angles, α and β, were calculated. The values of α and β were then correlated with intra-operative difficulty in insertion of the electrode array.

Results

Ninety-six children were included in the study. Of the seven patients who had an α angle of less than 50 degrees, the surgeon experienced difficulties in electrode insertion. However, there were four patients with an α angle of more than 50 degrees for whom the surgeon also experienced difficulties in electrode insertion. In all these patients, the β angle was more than 20 degrees.

Conclusion

Calculation of cochlear orientation and its angle with the surgical axis (α and β) can aid the planning of surgery, particularly with regard to the cochleostomy site and preservation of residual hearing.

Information

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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