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Updated: Jul 3, 2025
Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Radioclinical Assessment of Posterior Tympanotomy Difficulties during Ordinary Cochlear Implantation: A Prospective
Maurizio Barbara1, Valerio Margani1, Edoardo Covelli1
1Department of Neuroscience, Mental Health and Sensory Organs (NEMOS), Sant Andrea University Hospital, Sapienza University, Italy.
Objectives:
This study proposes a preoperative radiologic scoring system for predicting posterior tympanotomy (PT) and mastoidectomy-associated difficulties during cochlear implantation (CI).
Study Design:
It was a prospective case-series study.
Settings:
The included CI surgeries were performed at tertiary referral institutions from October 2022 to April 2023.
Subjects:
We included 73 CI candidates performed via the PT approach.
Intervention:
The proposed radiologic score, composed of 13 items, was fulfilled and evaluated before each CI surgery.
Main Outcome Measure:
We correlated this score with the intraoperative difficulty and surgical duration.
Results:
The operation was straightforward in 42 patients with a score of 3.87 ± 1.72 and challenging in 31 patients with a score of 10.66 ± 1.73. The radiologic score was strongly correlated with the surgical difficulty and duration (p < 0.0001).
Conclusions:
Our proposed radiologic score was a valid, reliable, and precise tool to predict intraoperative difficulty during cochlear implantation. Chorda-facial angle was the strongest predictor, significantly affecting the difficulty, surgical duration, and preoperative radiologic score. A score equal to or more than 7.5 was expected to be associated with surgical difficulty.
