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Comparative evaluation of round window niche accessibility pre-operatively on high-resolution computed tomography of the temporal bone with intra-operative findings

Published online by Cambridge University Press:  28 June 2019

R Sharma ,
R Meher ,
J C Passey ,
J Kumar ,
A Gupta  and
S Kharbanda
R Sharma*
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
R Meher
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
J C Passey
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
J Kumar
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
A Gupta
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India
S Kharbanda
Affiliation:
Department of Otorhinolaryngology, Lok Nayak Hospital, New Delhi, India
*
Author for correspondence: Dr Raman Sharma, Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’) Hospitals and Guru Nanak Eye Centre, University of Delhi, New Delhi, India 110002 E-mail: raman.96sharma@gmail.com
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Abstract

Objective

To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.

Methods

Nineteen patients scheduled for cochlear implantation, aged 2–20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings.

Results

The mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16–69.37°), 63.81° (58.61–71.35°) and 56.48° (50.37–59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016).

Conclusion

Pre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.

Keywords

Round WindowEarCochlear ImplantsEndoscopyFacial Recess ApproachComputed TomographyX-RayTemporal Bone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 575 - 579
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr R Sharma takes responsibility for the integrity of the content of the paper

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