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Imaging Criteria to Predict Surgical Difficulties During Stapes Surgery
Claire Parra1, Stéphanie Trunet, Benjamin Granger
1*Otorhinolaryngology, Creteil Hospital, Creteil †Radiology Department ‡Biostatistic, Public Health and Medical Information Department §Otorhinolaryngology Assistance Publique des Hôpitaux de Paris (APHP), Pitié Salpêtrière University Hospital ||Sorbonne University, UPMC univ Paris 6 ¶National Institute of Health and Medical Research Pierre and Marie Curie University (UPMC INSERM), UMR S-1159, Minimally Invasive Robot-based Hearing Rehabilitation #Brain and Spine Institute, Magnetoencephalography-Electroencephalography Center (MEG-EEG Center) (UMR 7225/U1127), Pierre and Marie Curie University (UPMC)/National Center of Scientific Research (CNRS)/National Institute of Health and Medical Research (INSERM), Paris, France.
Computed tomography (CT) scans accurately predict surgical difficulty in otosclerosis stapes surgery by measuring oval window width and facial-promontory angle, aiding surgeons in anticipating challenges.
Area of Science:
- Otolaryngology
- Medical Imaging
- Surgical Planning
Background:
- Stapes surgery for otosclerosis presents challenges due to restricted access to the oval window niche.
- Accurate preoperative assessment is crucial for managing potential surgical difficulties.
Purpose of the Study:
- To evaluate the accuracy of computed tomographic (CT) scans in measuring anatomical distances relevant to stapes surgery.
- To determine the reliability of CT scans in predicting surgical technical difficulties in otosclerosis cases.
Main Methods:
- A prospective study of 96 patients (101 ears) undergoing stapes surgery.
- Preoperative CT scans measured oval window niche dimensions and the facial-promontory angle.
- Intraoperative distances (stapes to facial nerve, promontory to facial nerve) and surgeon discomfort were recorded.
Main Results:
- CT measurements of oval window width and facial-promontory angle correlated with intraoperative distances and surgeon discomfort.
- A specific threshold for oval window width (1.1 mm) indicated a high likelihood of intraoperative difficulty (71% sensitivity, 84% specificity).
Conclusions:
- Preoperative CT imaging of oval window width and facial-promontory angle is a reliable tool for predicting operative difficulty in otosclerosis surgery.
- This analysis aids in surgical planning and managing potential challenges during stapes procedures.