Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T00:51:03.105Z Has data issue: false hasContentIssue false

Surgical considerations during cochlear implantation: the utility of temporal bone computed tomography

Published online by Cambridge University Press:  04 February 2021

Beomcho Jun
Affiliation:
Department of Otorhinolaryngology, Uijeongbu St Mary’s Hospital, College of Medicine, Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea
Sunwha Song*
Affiliation:
Department of Radiology, Uijeongbu St Mary’s Hospital, College of Medicine, Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea
*
Author for correspondence: Dr Sunwha Song, Department of Radiology, Uijeongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea E-mail: [email protected]

Abstract

Objective

This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography.

Methods

Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion.

Results

Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach.

Conclusion

It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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 S Song takes responsibility for the integrity of the content of the paper

References

Long, YT, Athar, PP, Mahmud, R, Saim, L. Management of iatrogenic facial nerve palsy and labyrinthine fistula in mastoid surgery. Asian J Surg 2004;27:176–9CrossRefGoogle ScholarPubMed
Çam, OH, Karataş, M. A Life threatening pitfall in ear surgery: extracranial sigmoid sinus. J Craniofac Surg 2015;26:e619–20CrossRefGoogle ScholarPubMed
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
Öztürk, K, Göde, S, Çelik, S, Orhan, M, Bilge, O, Bilgen, C et al. Revisiting the anatomy of the facial recess: the boundaries of the round window exposure. Balkan Med J 2016;33:552–5CrossRefGoogle ScholarPubMed
Karkas, A, Champfluer, NM, Uziel, A, Mondain, M, Puel, JL, Venail, F. Benefit of preoperative temporal bone CT for atraumatic cochlear implantation. Otol Neurotol 2018;39:e186–94CrossRefGoogle ScholarPubMed
Hamamoto, M, Murakami, G, Kataura, A. Topographical relationships among the facial nerve, chorda tympani nerve and round window with special reference to the approach route for cochlear implant surgery. Clin Anat 2000;13:251–63.0.CO;2-E>CrossRefGoogle ScholarPubMed
Luers, JC, Hüttenbrink, KB, Beutner, D. Surgical anatomy of the round window – implications for cochlear implantation. Clin Otolaryngol 2018;43:417–24CrossRefGoogle ScholarPubMed
Roland, PS, Wright, CG, Isaacson, B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope 2007;117:1397–402CrossRefGoogle ScholarPubMed
Zhou, L, Friedmann, DR, Treaba, C, Peng, R, Roland, JT Jr. Does cochleostomy location influence electrode trajectory and intracochlear trauma? Laryngoscope 2015;125:966–71CrossRefGoogle ScholarPubMed
Adunka, OF, Radeloff, A, Gstoettner, WK, Pillsbury, HC, Buchman, CA. Scala tympani cochleostomy II: topography and histology. Laryngoscope 2007;117:2195–200CrossRefGoogle ScholarPubMed
Meshik, X, Holden, TA, Chole, RA, Timothy, EH. Optimal cochlear implant insertion vectors. Otol Neurotol 2010;31:5869CrossRefGoogle ScholarPubMed
Breinbauer, HA, Praetorius, M. Variability of an ideal insertion vector for cochlear implantation. Otol Neurotol 2015;36:610–17CrossRefGoogle ScholarPubMed
Sahni, D, Singla, A, Gupta, A, Gupta, T, Aggarwal, A. Relationship of cochlea with surrounding neurovascular structures and their implication in cochlear implantation. Int J Pediatr Otorhinolaryngol 2010;74:701–3Google Scholar
Di Lella, F, Falcioni, M, Piccinini, S, Iaccarino, I, Bacciu, A, Pasanisi, E et al. Prevention and management of vascular complications in middle ear and cochlear implant surgery. Eur Arch Otorhinolaryngol 2017;274:3883–92CrossRefGoogle ScholarPubMed
Hara, M, Takahashi, H, Kanda, Y. The usefulness of reconstructed 3D images in surgical planning for cochlear implantation in a malformed ear with an abnormal course of the facial nerve. Clin Exp Otorhinolaryngol 2012;5:548–52CrossRefGoogle Scholar
Joshi, VM, Navleka, SK, Kishore, GR, Reddy, KJ, Kumar, EC. CT and MR imaging of the inner ear and brain in children with congenital sensorineural hearing loss. Radiographics 2012;32:683–98CrossRefGoogle Scholar
Nakamura, K, Dias, SM, Sasaki, T, Sugimoto, H, Hatano, M, Ito, M. Usefulness of reconstructed 3D images for cochlear implantation in a case with a facial nerve anomaly. Auris Nasus Larynx 2018;45:1103–6CrossRefGoogle Scholar