Radiologic Evaluation of the Round Window Niche Configuration: A One-Stop Approach

Area of Science:

• Otolaryngology
• Neurosurgery
• Radiology

Background:

• Accurate preoperative assessment of the round window niche is crucial for otologic surgery.
• Variations in round window niche anatomy can impact surgical planning and outcomes.

Purpose of the Study:

• To evaluate the utility of a single-axial computed tomography (CT) scan in predicting the round window niche configuration.
• To correlate radiological predictions with intraoperative findings and assess surgical planning implications.

Main Methods:

• Fifty patients underwent high-resolution CT, with a single axial slice at the cochlear aqueduct level analyzed.
• Radiological configurations (open, hooded, covered) were compared with intraoperative findings classified using the St. Thomas classification.
• Image analysis quantified drilling required for round window membrane exposure.

Main Results:

• A good concordance was observed between preoperative radiological predictions and intraoperative findings (P=.87751).
• The study identified 12 open, 17 hooded, and 21 covered niche configurations radiologically.
• Intraoperative findings included 12 Type I, 18 Type II, and 20 Type III configurations.

Conclusions:

• A single-axial CT scan is effective for predicting round window niche configuration.
• This imaging technique facilitates planning the optimal surgical approach and estimating drilling needs.
• Preoperative radiological assessment improves surgical precision in procedures involving the round window.