Ito Ken, Ishida Rumi, Karino Shotaro, Yamasoba Tatsuya
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Otol Neurotol. 2008 Feb;29(2):124-30. doi: 10.1097/MAO.0b013e318159e77f.
To describe our newly devised method of viewing intracochlear ossification for the purpose of minimizing bone drilling during cochlear implantation for partially ossified cochleas and to evaluate its usefulness.
Descriptive study that compares 1) conventional computed tomographic (CT) films with the newly devised CT movie and 2) preoperative evaluation using the CT movie with the findings during surgery.
University Hospital.
Four cochlear implantees with partial ossification of cochlea due to meningitis.
Diagnostic.
Reconstruction of high-resolution CT images of the temporal bone was performed using a multiplanar reformat software. By rotating the cochlear cross plane from the round window niche in the direction of the inferior segment by 5 degrees, 72 images were obtained for 360-degree rotation, which were converted to a movie using QuickTime Pro software. The preoperative evaluation and intraoperative findings were compared.
The advantage of CT movie over sequential CT films was facility in understanding the 3-dimensional space in the cochlea. Evaluation of the extent of the ossified region on CT movie corresponded to the intraoperative findings in all 4 patients. In 1 patient, the CT movie corrected an erroneous evaluation based on conventional CT films. However, additional drilling over the extent of ossification was necessitated in another patient because of scar tissue development.
Computed tomographic movie is considered an innovative new method for preoperative evaluation of ossified cochleas and is able to reduce human errors. However, additional drilling beyond ossified part can become necessary during surgery.
描述我们新设计的观察耳蜗内骨化的方法，以尽量减少部分骨化耳蜗人工耳蜗植入时的骨钻孔，并评估其效用。
描述性研究，比较1）传统计算机断层扫描（CT）胶片与新设计的CT电影，以及2）使用CT电影进行的术前评估与手术中的发现。
大学医院。
4名因脑膜炎导致耳蜗部分骨化的人工耳蜗植入者。
诊断性。
使用多平面重组软件对颞骨进行高分辨率CT图像重建。通过将耳蜗横断面从圆窗龛沿下部分方向旋转5度，360度旋转可获得72张图像，使用QuickTime Pro软件将其转换为电影。比较术前评估和术中发现。
与连续CT胶片相比，CT电影的优势在于便于理解耳蜗内的三维空间。CT电影对骨化区域范围的评估与所有4例患者的术中发现相符。在1例患者中，CT电影纠正了基于传统CT胶片的错误评估。然而，由于瘢痕组织形成，另1例患者在骨化范围之外仍需要额外钻孔。
计算机断层扫描电影被认为是术前评估骨化耳蜗的一种创新新方法，能够减少人为误差。然而，手术中可能仍需要在骨化部分之外进行额外钻孔。
