Fouad Yasser A, Elaassar Ahmad Shaker, El-Anwar Mohammad Waheed, Sabir Ebrahim, Abdelhamid Ahmad, Ghonimy Mai
*Department of Otorhinolaryngology, Head and Neck Surgery †Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig ‡Department of Radiodiagnosis, Faculty of Medicine, Cairo University, Cairo, Egypt.
Otol Neurotol. 2017 Sep;38(8):1097-1103. doi: 10.1097/MAO.0000000000001493.
High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed inner and middle ear anatomical information and enhances more efforts for better dependent correlation and measurements of round window (RW).
To find an applicable way by HRCT imaging for the prediction of the visibility of the RW during cochlear implantation (CI) surgery.
Five radiologic measurements were performed on the axial HRCT and these measurements were correlated with the degree of RW visibility after performing posterior tympanotomy during CI surgery.
Sixty ears of 60 children were included in the current study. A significant correlation was found between the degree of RW visibility and the following: 1) the angle between RW, facial nerve (FN), and the coronal axis (p < 0.00001); 2) the vertical distance between RW and FN (p = 0.006552); and 3) FN location to the axis of cochlea (p = 0.000419). On the other hand, nonsignificant correlation was found between the degree of RW visibility and both of the facial recess width and the angle between axis of cochlea and external auditory canal (p = 0.941363 and p = 0.59036 respectively).
The angle between RW, FN, and the coronal axis and the vertical distance between RW and FN are proportionate with the degree of surgical RW visibility in children during CI. In children, surgeons can depend on those two parameters in addition to the distance between FN location to the axis of cochlea in predicting the RW visibility rather than depending on the measurements related to the external auditory canal.
高分辨率计算机断层扫描（HRCT）增强了术前成像在获取详细中耳和内耳解剖信息方面的作用，并加大了对圆窗（RW）进行更好的相关性研究和测量的力度。
通过HRCT成像找到一种适用于预测人工耳蜗植入（CI）手术中圆窗可见性的方法。
在轴向HRCT上进行五项放射学测量，并将这些测量结果与CI手术中进行后鼓室切开术后圆窗的可见程度相关联。
本研究纳入了60名儿童的60只耳朵。发现圆窗可见程度与以下因素之间存在显著相关性：1）圆窗、面神经（FN）与冠状轴之间的夹角（p<0.00001）；2）圆窗与FN之间的垂直距离（p=0.006552）；3）FN相对于耳蜗轴的位置（p=0.000419）。另一方面，未发现圆窗可见程度与面神经隐窝宽度以及耳蜗轴与外耳道之间的夹角存在显著相关性（分别为p=0.941363和p=0.59036）。
在CI手术中，儿童圆窗、FN与冠状轴之间的夹角以及圆窗与FN之间的垂直距离与手术中圆窗的可见程度成正比。在儿童中，外科医生在预测圆窗可见性时，除了FN相对于耳蜗轴的距离外，还可依赖这两个参数，而不是依赖于与外耳道相关的测量值。
