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Surgical and Radiologic Anatomy

, Volume 40, Issue 6, pp 705–711 | Cite as

Preoperative evaluation of cochlear implantation through the round window membrane in the facial recess using high-resolution computed tomography

  • Xie Li-Hong 
  • Tang Jie 
  • Miao Wen-Jie 
  • Tang Xiang-Long 
  • Li Heng 
  • Tang An-Zhou 
Original Article
  • 146 Downloads

Abstract

Purpose

We evaluated the risk of cochlear implantation through the round window membrane in the facial recess through a preoperative analysis of the angle between the facial nerve-round window and the cranial midline using high-resolution temporal bone CT.

Methods

Temporal bone CT films of 176 patients with profound sensorineural hearing loss at our hospital from 2013 to 2015 were reviewed. The preoperative temporal bone CT scans of the patients were retrospectively analysed. The vertical distance (d value) from the leading edge of the facial nerve to the posterior wall of the external auditory canal and the angle (α value) between the line from the leading edge of the facial nerve to the midpoint of the round window membrane and the median sagittal line on the round window membrane plane were measured. Based on intraoperative observation, the round window membrane was divided into complete round window membrane exposure (group A), partial exposure (group B), and unexposed (group C) groups, and statistical analysis was performed.

Results

The α value could be effectively measured for all 176 patients (62.60 ± 7.12), and the d value could be effectively measured for 95 cases (5.53 ± 1.00). An analysis of the correlation between the α and d values of these 95 cases found a negative correlation. Of the 176 cases, one-way analysis of variance (ANOVA) showed that the differences among the groups were significant [P = 0.000 (< 0.05)].

Conclusion

The angle (α value) between the line connecting the leading edge of the facial nerve to the midpoint of the round window and the median sagittal line measured in preoperative CT scans was associated with the difficulty of intraoperatively exposing the round window membrane. When the α value was larger than a certain degree, the difficulty of exposing the round window membrane was increased. In such cases, the surgeon should fully expose the round window membrane during surgery, which could result decrease the likelihood of complications.

Keywords

Temporal bone high-resolution computed tomography Cochlear implantation Round window membrane Facial nerve 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Antonelli PJ, Varela AE, Mancuso AA (1999) Diagnostic yield of high-resolution computed tomography for pediatric sensorineural hearing loss. Laryngoscope 109:1642–1647.  https://doi.org/10.1097/00005537-199910000-00018 CrossRefPubMedGoogle Scholar
  2. 2.
    Bartling SH, Gupta R, Torkos A, Dullin C, Eckhardt G, Lenarz T, Becker H, Stover T (2006) Flat-panel volume computed tomography for cochlear implant electrode array examination in isolated temporal bone specimens. Otol Neurotol 27:491–498.  https://doi.org/10.1097/01.mao.0000194816.15298.50 PubMedCrossRefGoogle Scholar
  3. 3.
    Briggs RJ (2011) Future technology in cochlear implants: assessing the benefit. Cochlear Implants Int 12(Suppl 1):S22–S25.  https://doi.org/10.1179/146701011X13001035752291 CrossRefPubMedGoogle Scholar
  4. 4.
    Emal T (2016) Cochlear implantation in a subject with a narrow facial recess: Importance of preoperative radiological findings. Cochlear Implants Int 17:158–161.  https://doi.org/10.1080/14670100.2016.1177261 CrossRefPubMedGoogle Scholar
  5. 5.
    Kaiyu H, Zhenchang W (2013) The anatomic study of the round window and round window niche by the volume CT. Chin J Clin Radiol 7:938–942Google Scholar
  6. 6.
    Kant AR, Pathak S (2015) Qualitative assessment of speech perception performance of early and late cochlear implantees. Indian J Otolaryngol Head Neck Surg 67:292–298.  https://doi.org/10.1007/s12070-015-0881-0 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Kriegs JO, Churakov G, Kiefmann M, Jordan U, Brosius J, Schmitz J (2006) Retroposed elements as archives for the evolutionary history of placental mammals. PLoS Biol 4:e91.  https://doi.org/10.1371/journal.pbio.0040091 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Leong AC, Jiang D, Agger A, Fitzgerald-O’Connor A (2013) Evaluation of round window accessibility to cochlear implant insertion. Eur Arch Otorhinolaryngol 270:1237–1242.  https://doi.org/10.1007/s00405-012-2106-4 CrossRefPubMedGoogle Scholar
  9. 9.
    Liang Z, Jiandong L, Xiaobai C (2012) Facial nerve canal and its relationship with adjacent structures on HRCT. Chin Arch Otolaryngol Head Neck Surg 2:69–72Google Scholar
  10. 10.
    Ma H, Han P, Liang B, Tian ZL, Lei ZQ, Kong WJ, Feng GS (2008) Multislice spiral computed tomography imaging in congenital inner ear malformations. J Comput Assist Tomogr 32:146–150.  https://doi.org/10.1097/rct.0b013e318063c64a CrossRefPubMedGoogle Scholar
  11. 11.
    Mackeith S, Joy R, Robinson P, Hajioff D (2012) Pre-operative imaging for cochlear implantation: magnetic resonance imaging, computed tomography, or both? Cochlear Implants Int 13:133–136.  https://doi.org/10.1179/1754762811Y.0000000002 CrossRefPubMedGoogle Scholar
  12. 12.
    Majdani O, Olze H (2013) Cochlear implantation-evaluation of round window membrane accessibility. Laryngorhinootologie 92:792–793CrossRefPubMedGoogle Scholar
  13. 13.
    Marchioni D, Soloperto D, Colleselli E, Tatti MF, Patel N, Jufas N (2016) Round window chamber and fustis: endoscopic anatomy and surgical implications. Surg Radiol Anat SRA.  https://doi.org/10.1007/s00276-016-1662-5 PubMedCrossRefGoogle Scholar
  14. 14.
    Park E, Amoodi H, Kuthubutheen J, Chen JM, Nedzelski JM, Lin VY (2015) Predictors of round window accessibility for adult cochlear implantation based on pre-operative CT scan: a prospective observational study. J Otolaryngol Head Neck Surg 44:20.  https://doi.org/10.1186/s40463-015-0073-7 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Pelosi S, Noble JH, Dawant BM, Labadie RF (2013) Analysis of intersubject variations in intracochlear and middle ear surface anatomy for cochlear implantation. Otol Neurotol 34:1675–1680.  https://doi.org/10.1097/MAO.0b013e3182a1a7e6 CrossRefPubMedGoogle Scholar
  16. 16.
    Zhou B, Lin S, Lin Y, Fang Z, Ye S, Zhang R (2015) Imaging and audiology analysis of the congenital inner ear malformations. J Clin Otorhinolaryngol Head Neck surgery 29:1950–1953Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Xie Li-Hong 
    • 1
  • Tang Jie 
    • 1
  • Miao Wen-Jie 
    • 1
  • Tang Xiang-Long 
    • 1
  • Li Heng 
    • 1
  • Tang An-Zhou 
    • 1
  1. 1.Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina

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