Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery
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Identification of the endolymphatic sac has failed occasionally. Postoperative complications have also rarely been reported. Given a safer and more reliable surgery, preoperative anatomical assessments are valuable, however, the vestibular aqueduct has seldom been seen with multi-planar reconstruction (MPR) computed tomography (CT) images yet. Our study aimed to determine the significance and utility of volume-rendered (VR) CT images of the surgical field for identifying the vestibular aqueduct, compared with MPR CT images.
Subjects and methods
14 patients with Meniere’s disease who underwent endolymphatic sac surgery between 2008 and 2011. Location and size of the vestibular aqueduct were assessed using VR and MPR CT images, independently.
Accuracy of identifying the location differed significantly between VR and MPR CT images (rate of total correct evaluations: 100% by VR CT images vs 75% by MPR CT images, p = 0.02). Size was correctly identified in cases with a small endolymphatic sac using VR CT images (rate of total correct evaluations for size of the vestibular aqueduct: 100% by VR CT vs 57% by MPR CT, p = 0.046). VR CT images also demonstrated clearly the relationship between the endolymphatic sac and high jugular bulb. In two cases, the endolymphatic sac was identified by VR images, not by MPR images.
Accurate information about the location and size of vestibular aqueduct can allow sac surgeons to identify a tiny endolymphatic sac more easily and certainly, and also aids surgical trainees to learn sac surgery safely.
KeywordsMeniere’s disease Endolymphatic sac Cone-beam CT Volume-rendering technique Three-dimensional image
There was no financial and material support for this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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- 8.Shambaugh GE Jr (1966) Surgery of endolymphatic sac. Arch Otolaryngol 83:301–315Google Scholar
- 9.House WF (1975) Meniere’s disease: management and therapy. Otolaryngol Clin N Am 8:515–535Google Scholar
- 11.Me´nie`re P (1861) Sur une forme de surdite´ grave de´pendant d’une le´sion de l’oreille interne [in French]. Gaz Me´d de Paris 16:29Google Scholar
- 15.Yazawa Y, Suzuki M, Tanaka H, Kitano H, Kitajima K (1998) Surgical observation on the endolymphatic Sac in Meniere’s disease. Am J Otol 19:71–75Google Scholar
- 17.Arenberg IK, Balkany TJ (1982) Prevention of complications and failures in endolymphatic system surgery. Otolaryngol Clin North Am 15:869–882Google Scholar
- 26.Clemis JD, Valvassori GE (1968) Recent radiographic and clinical observations on the vestibular aqueduct. Otolaryngol Clin North Am 1:339–346Google Scholar
- 35.Komori M, Yanagihara N, Hinohira Y, Kashiba K, Miuchi S, Kishida Y (2012) Quality of temporal bone CT images: a comparison of flat panel cone beam CT and multi-slice CT. Int Adv Otol 8:57–62Google Scholar
- 37.Arenberg IK, Jackson CG, Gardner G, Huang TS, Hughes G, Neely JG, Paparella M, Steenerson RL, Wright JW (1987) 3rd. Panel discussion: the surgical anatomy and fine points of endolymphatic system surgery. Am J Otol 8:345–354Google Scholar