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Original article
Submitted: 2023-10-12
Accepted: 2023-11-20
Published online: 2023-12-21
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Selected structures of middle ear relevant to cochlear implantation on the basis of computer tomography

Katarzyna Amernik1, Michał Mielnik1, Aleksandra Gawlikowska-Sroka2, Edyta A. Dzięciołowska-Baran2
·
Pubmed: 38152919
Affiliations
  1. Department of Otolaryngology for Adults and Children and Otolaryngological Oncology, Pomeranian Medical University, Szczecin, Poland
  2. Department of Normal Anatomy, Pomeranian Medical University, Szczecin, Poland

open access

Ahead of Print
ORIGINAL ARTICLES
Submitted: 2023-10-12
Accepted: 2023-11-20
Published online: 2023-12-21

Abstract

Background: The primary objective of this study was to analyze middle ear structures critical for cochlear implantation using computed tomography.

Materials and methods: Patients who underwent cochlear implantation at the Department of Otolaryngology in Szczecin between 2015 and 2022 were eligible for the study. We analyzed computed tomography images of 57 ears in 52 patients. The following parameters were assessed: mastoid aeration, tegmen tympani height, sigmoid sinus position, posterior tympanotomy width, the distance between the facial nerve and chorda tympani, modified facial recess distance, and the prediction line described by other authors.

Results: In 69% of patients, after the removal of the round window bony overhang, the round window membrane became fully visible. There were no statistically significant correlations found for parameters describing mastoid process anatomy or those rating the width of the posterior tympanotomy concerning round window access. The prediction lines, according to Kashio and Jwair, were found to be relevant. In cases where patients' access to the niche and membrane of the window was rated as good or very good during clinical evaluation, they were more likely to describe the window as being located posteriorly or medially in the radiological evaluation. Using a binary Jwair scale provided a better correlation with the clinical assessment. In cases where the windows were graded as posterior, the clinical assessment indicated better surgical access, especially to the RWM (Round Window Membrane).

Conclusions: Evaluating middle ear anatomy on a computed tomography scan is useful for preparing for middle ear surgery but does not significantly affect the ability to access the round window. For such access, the position of the window in relation to the facial nerve is the most relevant factor, and measurements based on this relationship hold the highest clinical value.

Abstract

Background: The primary objective of this study was to analyze middle ear structures critical for cochlear implantation using computed tomography.

Materials and methods: Patients who underwent cochlear implantation at the Department of Otolaryngology in Szczecin between 2015 and 2022 were eligible for the study. We analyzed computed tomography images of 57 ears in 52 patients. The following parameters were assessed: mastoid aeration, tegmen tympani height, sigmoid sinus position, posterior tympanotomy width, the distance between the facial nerve and chorda tympani, modified facial recess distance, and the prediction line described by other authors.

Results: In 69% of patients, after the removal of the round window bony overhang, the round window membrane became fully visible. There were no statistically significant correlations found for parameters describing mastoid process anatomy or those rating the width of the posterior tympanotomy concerning round window access. The prediction lines, according to Kashio and Jwair, were found to be relevant. In cases where patients' access to the niche and membrane of the window was rated as good or very good during clinical evaluation, they were more likely to describe the window as being located posteriorly or medially in the radiological evaluation. Using a binary Jwair scale provided a better correlation with the clinical assessment. In cases where the windows were graded as posterior, the clinical assessment indicated better surgical access, especially to the RWM (Round Window Membrane).

Conclusions: Evaluating middle ear anatomy on a computed tomography scan is useful for preparing for middle ear surgery but does not significantly affect the ability to access the round window. For such access, the position of the window in relation to the facial nerve is the most relevant factor, and measurements based on this relationship hold the highest clinical value.

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Keywords

cochlear implant, posterior tympanotomy, round window, facial nerve, mastoid process

About this article
Title

Selected structures of middle ear relevant to cochlear implantation on the basis of computer tomography

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2023-12-21

Page views

182

Article views/downloads

150

DOI

10.5603/fm.97820

Pubmed

38152919

Keywords

cochlear implant
posterior tympanotomy
round window
facial nerve
mastoid process

Authors

Katarzyna Amernik
Michał Mielnik
Aleksandra Gawlikowska-Sroka
Edyta A. Dzięciołowska-Baran

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