Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T08:07:22.607Z Has data issue: false hasContentIssue false

Pre-operative assessment of facial recess width in paediatric cochlear implant recipients: a radiological study

Published online by Cambridge University Press:  28 September 2021

S Han
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, People's Republic of China
L Wang*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, People's Republic of China
F Gao
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, People's Republic of China
W Liang
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, People's Republic of China
T H Lee
Affiliation:
LAC+USC Medical Center, Los Angeles, California, USA
K A Peng
Affiliation:
House Clinic and House Institute Foundation, Los Angeles, California, USA
*
Author for correspondence: Dr Line Wang, Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95th Yong'an Road, Xicheng District, Beijing100050, People's Republic of China E-mail: wlebjyy@126.com

Abstract

Background

The location of the vertical segment of the facial nerve varies greatly among patients undergoing otological surgery. Its position relative to the incus determines facial recess width, which has implications for ease of cochlear implantation.

Objective

To investigate the variation in facial nerve depth, relative to the incus, on pre-operative computed tomography in patients undergoing cochlear implantation.

Methods

A retrospective cohort study was conducted of paediatric patients undergoing cochlear implantation at a tertiary referral centre. Distance between the incus short process and facial nerve, in the transverse (medial-lateral) dimension, was measured at six imaging slices, ranging from 1.25 to 7.25 mm below the tip of the incus short process.

Results

Facial nerve depth relative to the incus short process demonstrated significant variability. Among all subjects and at all measurements taken inferior to the incus, the mean dimension between the facial nerve and the incus short process was 1.71 mm.

Conclusion

This paper presents a rapid, repeatable technique to assess the depth of the facial nerve vertical segment on pre-operative computed tomography, as measured relative to the tip of the incus short process. This allows the surgeon to anticipate facial recess width and round window access during cochlear implantation.

Type
Main Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr L Wang takes responsibility for the integrity of the content of the paper

References

Green, JD Jr, Shelton, C, Brackmann, DE. Iatrogenic facial nerve injury during otologic surgery. Laryngoscope 1994;104:922–6CrossRefGoogle ScholarPubMed
Dexian Tan, A, Ng, JH, Lim, SA, Low, DY, Yuen, HW. Classification of temporal bone pneumatization on high-resolution computed tomography: prevalence patterns and implications. Otolaryngol Head Neck Surg 2018;159:743–9CrossRefGoogle ScholarPubMed
Aslan, A, Goktan, C, Okumus, M, Tarhan, S, Unlu, H. Morphometric analysis of anatomical relationships of the facial nerve for mastoid surgery. J Laryngol Otol 2001;115:447–9CrossRefGoogle ScholarPubMed
Eby, TL. Development of the facial recess: implications for cochlear implantation. Laryngoscope 1996;106:17CrossRefGoogle ScholarPubMed
Pulec, JL. The facial nerve: how to find it. Ear Nose Throat J 1993;72:677–85CrossRefGoogle Scholar
Jain, S, Deshmukh, PT, Lakhotia, P, Kalambe, S, Chandravanshi, D, Khatri, M. Anatomical study of the facial recess with implications in round window visibility for cochlear implantation: personal observations and review of the literature. Int Arch Otorhinolaryngol 2019;23:e281–91Google ScholarPubMed
Calli, C, Pinar, E, Oncel, S, Tatar, B, Tuncbilek, MA. Measurements of the facial recess anatomy: implications for sparing the facial nerve and chorda tympani during posterior tympanotomy. Ear Nose Throat J 2010;89:490–4Google ScholarPubMed
Young, YS, Nadol, JB Jr. Dimensions of the extended facial recess. Ann Otol Rhinol Laryngol 1989;98:336–8CrossRefGoogle ScholarPubMed
Su, WY, Marion, MS, Hinojosa, R, Matz, GJ. Anatomical measurements of the cochlear aqueduct, round window membrane, round window niche, and facial recess. Laryngoscope 1982;92:483–6CrossRefGoogle ScholarPubMed
Zou, T, Xie, N, Guo, M, Shu, F, Zhang, H. Applied anatomy of facial recess and posterior tympanum related to cochlear implantation [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012;26:445–8Google Scholar
Bielamowicz, SA, Coker, NJ, Jenkins, HA, Igarashi, M. Surgical dimensions of the facial recess in adults and children. Arch Otolaryngol Head Neck Surg 1988;114:534–7CrossRefGoogle ScholarPubMed