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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: [email protected]

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

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Footnotes

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

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