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A high-resolution computed tomography based scoring system to predict ease of electrode insertion in cochlear implantation

Published online by Cambridge University Press:  30 September 2021

A Das
Affiliation:
Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India
M Janweja*
Affiliation:
Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India
A Dubey
Affiliation:
Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India
S Mitra
Affiliation:
Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India
A Sengupta
Affiliation:
Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India
*
Author for correspondence: Dr M Janweja, Institute of Otorhinolaryngology and Head & Neck Surgery, Institute of Post-Graduate Medical Education and Research, Kolkata, India E-mail: [email protected]

Abstract

Objective

This study aimed to formulate a scoring system based on high-resolution computed tomography scans to predict ease of electrode insertion during cochlear implantation via posterior tympanotomy in paediatric patients.

Method

A scoring system Cochlear Implantation Radiological Assessment Score (CIRAS) was formulated based on six parameters. This score was correlated with intra-operative findings, and receiver operating characteristic analysis was performed to determine the optimal cut-off score to predict difficulty of surgery and to establish the inherent validity of the scoring system by area under curve.

Results

Receiver operating characteristic analysis showed that optimal cut-off score was 8 (93.1 per cent specificity and 56.52 per cent sensitivity), and area under the curve was 0.828. Patients with CIRAS of more than 8 had significantly higher time for surgery (p < 0.05).

Conclusion

CIRAS is an easy to administer tool by utilising classical axial and coronal sections, without any numerical measures. Pre-operative assessment by this score gives a good idea of intra-operative challenges.

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

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Footnotes

Dr M Janweja takes responsibility for the integrity of the content of the paper

References

Mandour, M, Tomoum, M, Zayat, S El, Hamad, H, Amer, M. Surgeon oriented preoperative radiologic evaluation in cochlear implantation - Our experience with a proposed checklist. Int Arch Otorhinolaryngol 2019;23:137–41Google ScholarPubMed
Mandour, MF, Khalifa, MA, Khalifa, HA, Tomoum, MO. A novel radiologic check test of round window accessibility for cochlear implantation: Our experience in 198 cases. Clin Otolaryngol 2017;42:1108–11CrossRefGoogle ScholarPubMed
Alam-Eldeen, MH, Rashad, UM, Ali, AHA. Radiological requirements for surgical planning in cochlear implant candidates. Indian J Radiol Imaging 2017;28:167–76Google Scholar
Friedland, DR, Runge-Samuelson, C. Soft cochlear implantation: rationale for the surgical approach. Trends Amplif 2009;13:124–38CrossRefGoogle ScholarPubMed
Adunka, O, Gstoettner, W, Hambek, M, Unkelbach, MH, Radeloff, A, Kiefer, J. Preservation of basal inner ear structures in cochlear implantation. ORL J Otorhinolaryngol Relat Spec 2004;66:306–12CrossRefGoogle ScholarPubMed
Adunka, OF, Buchman, CA. Scala tympani cochleostomy I: results of a survey. Laryngoscope 2007;117:2187–94CrossRefGoogle ScholarPubMed
Pendem, SK, Rangasami, R, Arunachalam, RK, Mohanarangam, VSP, Natarajan, P. HRCT correlation with round window identification during cochlear implantation in children. J Clin Imaging Sci 2014;4:70CrossRefGoogle ScholarPubMed
Vaid, S, Vaid, N, Manikoth, M, Zope, A. Role of HRCT and MRI of the temporal bone in predicting and grading the degree of difficulty of cochlear implant surgery. Indian J Otolaryngol Head Neck Surg 2015;67:150–8CrossRefGoogle ScholarPubMed
Park, E, Amoodi, H, Kuthubutheen, J, Chen, JM, Nedzelski, JM, Lin, VYW. Predictors of round window accessibility for adult cochlear implantation based on pre-operative CT scan: a prospective observational study. J Otolaryngol Head Neck Surg 2015;44:17CrossRefGoogle ScholarPubMed
Dreisbach, JN, Balkany, TJ, Seibert, CE. Radiographic imaging of the cochlear implant candidate: preliminary results. Otolaryngol Neck Surg 1986;95:592–7Google Scholar
Wang, L, Yang, J, Jiang, C, Zhang, D. Cochlear implantation surgery in patients with narrow facial recess. Acta Otolaryngol 2013;133:935–8CrossRefGoogle ScholarPubMed
Kashio, A, Sakamoto, T, Karino, S, Kakigi, A, Iwasaki, S, Yamasoba, T. Predicting round window niche visibility via the facial recess using high-resolution computed tomography. Otol Neurotol 2015;36:e1823CrossRefGoogle ScholarPubMed
Elzayat, S, Mandour, M, Lotfy, R, Mahrous, A. Predicting round window visibility during cochlear implantation using high resolution CT scan. J Int Adv Otol 2018;14:1517CrossRefGoogle ScholarPubMed
Sun, D-I, Lee, D, Jang, K-H et al. A suggested new classification system for the anatomic variations of the sigmoid sinus: a preliminary study. J Int Adv Otol 2009;5:15Google Scholar
Woolley, AL, Oser, AB, Lusk, RP, Bahadori, RS. Preoperative temporal bone computed tomography scan and its use in evaluating the pediatric cochlear implant candidate. Laryngoscope 1997;107:1100–06CrossRefGoogle ScholarPubMed