Mandour Mahmoud, Tomoum Mohammed, El Zayat Saad, Hamad Hisham, Amer Mohamed
Department of ORL-HNS, Tanta University Faculty of Medicine, Tanta, Egypt.
Department of ORL-HNS, Kafrelsheikh University, Kafr el-Sheikh, Egypt.
Int Arch Otorhinolaryngol. 2019 Apr;23(2):137-141. doi: 10.1055/s-0038-1648247. Epub 2018 May 9.
Preoperative temporal bone imaging studies have been routinely performed prior to cochlear implantation. Radiologists need to report these examinations with special focus on the surgeon's expectations. To provide a basic structured format, in the form of a checklist, for reporting preoperative computed tomography (CT) and to its clinical impact on operative findings. The preoperative temporal bone CT scans of 47 patients were analyzed and reported according to the proposed checklist. Intraoperative assessment of mastoidectomy, posterior tympanotomy and round window access was done by the surgeon in a blinded fashion and were correlated with the radiological findings to assess its significance. The proposed radiological checklist was reliable in assessing operative difficulty during cochlear implantation. Contracted mastoid and lower tegmen position were associated with a greater difficulty of the cortical mastoidectomy. Presence of an air cell around the facial nerve (FN) was predictive of easier facial recess access exposure. Facial nerve location and posterior external auditory canal (EAC) wall inclination were predictive of difficult round window (RW) accessibility. Certain parameters on the preoperative temporal bone CT scan may be useful in predicting potential difficulties encountered during the key steps involved in cochlear implant surgery.
术前颞骨成像研究在人工耳蜗植入术前已常规进行。放射科医生在报告这些检查时需要特别关注外科医生的期望。
为提供一种以清单形式呈现的基本结构化格式，用于报告术前计算机断层扫描（CT）及其对手术结果的临床影响。
根据所提议的清单对47例患者的术前颞骨CT扫描进行分析和报告。外科医生以盲法对乳突切除术、后鼓室切开术和圆窗入路进行术中评估，并将其与放射学结果相关联，以评估其意义。
所提议的放射学清单在评估人工耳蜗植入术中的手术难度方面是可靠的。乳突收缩和 tegmen 位置较低与皮质乳突切除术难度较大相关。面神经（FN）周围存在气房预示着面神经隐窝入路暴露更容易。面神经位置和外耳道后壁倾斜度可预测圆窗（RW）进入困难。
术前颞骨CT扫描上的某些参数可能有助于预测人工耳蜗植入手术关键步骤中可能遇到的潜在困难。
