Round Window Accessibility Prediction in Cochlear Implant Surgery
Background: Clear identification of the round window (RW) through the facial recess is a key surgical step for successful cochlear implantation (CI) surgery, which may be very challenging in some cases. Objective is to predict round window (RW) accessibility during CI surgery using high-resolution c...
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| Format: | Article |
| Language: | English |
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2024-11-01
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| Series: | Journal of International Advanced Otology |
| Online Access: | https://www.advancedotology.org/en/round-window-accessibility-prediction-in-cochlear-implant-surgery-131964 |
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| author | Salah-eddine Youbi Omar Oulghoul Youssef Lakhdar Atmane Zaroual Mohamed Chehbouni Othmane Benhoummad Youssef Rochdi Abdelaziz Raji |
| author_facet | Salah-eddine Youbi Omar Oulghoul Youssef Lakhdar Atmane Zaroual Mohamed Chehbouni Othmane Benhoummad Youssef Rochdi Abdelaziz Raji |
| author_sort | Salah-eddine Youbi |
| collection | DOAJ |
| description | Background: Clear identification of the round window (RW) through the facial recess is a key surgical step for successful cochlear implantation (CI) surgery, which may be very challenging in some cases. Objective is to predict round window (RW) accessibility during CI surgery using high-resolution computed tomography (HRCT).
Methods: We retrospectively reviewed preoperative HRCT scans of 142 patients who underwent CI surgery via the standard posterior tympanotomy approach at our ENT Head and Neck Surgery department. Surgical accessibility of the RW was assessed according to 2 methods, similar to the ones introduced by Mandour et al and Elzayat et al. Pre-operative imaging findings were then compared to the actual surgical accessibility of the RW by reviewing surgical notes and video recordings.
Results: Difficult surgical access to the RW was correctly predicted in our series by Mandour’s method in 81.8% of the cases, with a sensitivity and specificity of 56.3% and 96.4%, respectively, and by Elzayat’s method in 72.2% of the cases, with a sensitivity and specificity of 50% and 94.5%, respectively. Combining both methods showed an increase in sensitivity levels (Se=71.9%). When the 2 methods both predicted difficult RW access, there was a strong probability that drilling a cochleostomy would be necessary for safe electrode insertion along the scala tympani of the basal turn of the cochlea (P < .001).
Conclusion: These 2 methods are both simple and reliable tools that can help the surgeon anticipate difficult surgical access and prepare for the potential use of alternative techniques. |
| format | Article |
| id | doaj-art-7716d229f0b741619ecb7b66416add12 |
| institution | Kabale University |
| issn | 2148-3817 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | AVES |
| record_format | Article |
| series | Journal of International Advanced Otology |
| spelling | doaj-art-7716d229f0b741619ecb7b66416add122025-01-30T08:49:51ZengAVESJournal of International Advanced Otology2148-38172024-11-0120648949310.5152/iao.2024.231368Round Window Accessibility Prediction in Cochlear Implant SurgerySalah-eddine Youbi0https://orcid.org/0009-0008-7917-704XOmar Oulghoul1https://orcid.org/0000-0003-4408-3445Youssef Lakhdar2https://orcid.org/0000-0001-8028-0417Atmane Zaroual3https://orcid.org/0000-0001-9824-1539Mohamed Chehbouni4https://orcid.org/0000-0002-3397-8334Othmane Benhoummad5https://orcid.org/0000-0001-8700-1046Youssef Rochdi6https://orcid.org/0000-0001-7410-9672Abdelaziz Raji7https://orcid.org/0000-0002-9783-724XDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, University Hospital Center Souss Massa, Agadir, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoDepartment of ENT Head and Neck Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, University Hospital Center Mohammed VI, Marrakech, MoroccoBackground: Clear identification of the round window (RW) through the facial recess is a key surgical step for successful cochlear implantation (CI) surgery, which may be very challenging in some cases. Objective is to predict round window (RW) accessibility during CI surgery using high-resolution computed tomography (HRCT). Methods: We retrospectively reviewed preoperative HRCT scans of 142 patients who underwent CI surgery via the standard posterior tympanotomy approach at our ENT Head and Neck Surgery department. Surgical accessibility of the RW was assessed according to 2 methods, similar to the ones introduced by Mandour et al and Elzayat et al. Pre-operative imaging findings were then compared to the actual surgical accessibility of the RW by reviewing surgical notes and video recordings. Results: Difficult surgical access to the RW was correctly predicted in our series by Mandour’s method in 81.8% of the cases, with a sensitivity and specificity of 56.3% and 96.4%, respectively, and by Elzayat’s method in 72.2% of the cases, with a sensitivity and specificity of 50% and 94.5%, respectively. Combining both methods showed an increase in sensitivity levels (Se=71.9%). When the 2 methods both predicted difficult RW access, there was a strong probability that drilling a cochleostomy would be necessary for safe electrode insertion along the scala tympani of the basal turn of the cochlea (P < .001). Conclusion: These 2 methods are both simple and reliable tools that can help the surgeon anticipate difficult surgical access and prepare for the potential use of alternative techniques.https://www.advancedotology.org/en/round-window-accessibility-prediction-in-cochlear-implant-surgery-131964 |
| spellingShingle | Salah-eddine Youbi Omar Oulghoul Youssef Lakhdar Atmane Zaroual Mohamed Chehbouni Othmane Benhoummad Youssef Rochdi Abdelaziz Raji Round Window Accessibility Prediction in Cochlear Implant Surgery Journal of International Advanced Otology |
| title | Round Window Accessibility Prediction in Cochlear Implant Surgery |
| title_full | Round Window Accessibility Prediction in Cochlear Implant Surgery |
| title_fullStr | Round Window Accessibility Prediction in Cochlear Implant Surgery |
| title_full_unstemmed | Round Window Accessibility Prediction in Cochlear Implant Surgery |
| title_short | Round Window Accessibility Prediction in Cochlear Implant Surgery |
| title_sort | round window accessibility prediction in cochlear implant surgery |
| url | https://www.advancedotology.org/en/round-window-accessibility-prediction-in-cochlear-implant-surgery-131964 |
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