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Predictors of round window membrane visibility in pediatric cochlear implant surgery using temporal bone HRCT: A

Jianqing Chen1, Yingwei Wu2, Jun Shi1

  • 1Department of Otolaryngology, Head & Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China.

International Journal of Pediatric Otorhinolaryngology
|March 27, 2019
PubMed

Insights

High-resolution CT scans can predict round window membrane visibility in infants undergoing cochlear implantation. Two specific angular measurements derived from HRCT reliably guide surgeons in identifying optimal electrode insertion sites in young children.

Area of Science:

  • Otolaryngology
  • Medical Imaging
  • Pediatric Surgery

Background:

  • Cochlear implantation in infants requires precise surgical planning.
  • Round window membrane (RWM) visibility is crucial for electrode insertion.
  • Predicting RWM visibility preoperatively can optimize surgical approaches.

Purpose of the Study:

  • To predict round window membrane (RWM) visibility and electrode insertion sites using high-resolution computed tomography (HRCT).
  • To evaluate the correlation between radiologic parameters and RWM visibility in pediatric cochlear implant surgery.

Main Methods:

  • Sixty-two ears from 36 infants under one year old were analyzed.
  • Preoperative axial temporal HRCT images were used to measure radiologic parameters.
  • Intraoperative RWM visibility was classified, and correlations with HRCT measurements were assessed.

Main Results:

  • A significant correlation was found between RWM visibility and two angular measurements (Angle A and Angle B) derived from HRCT (P < 0.01).
  • These angular measurements showed strong predictive power (R² = -0.809 and R² = -0.850).
  • Facial recess width did not show a significant correlation with RWM visibility (P > 0.05).

Conclusions:

  • RWM visibility in infants undergoing cochlear implantation is highly correlated with two specific angular measurements from HRCT.
  • These parameters are associated with optimal electrode insertion sites.
  • Surgeons can reliably use these two angular measurements to predict RWM visibility in children under one year old.
Abstract

Keywords:
Cochlear implantHRCTRound window membraneSurgical visibility

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