Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso.
Department of Neuroscience DNS, Otolaryngology Unit, University of Padova, Padova.
Otol Neurotol. 2020 Sep;41(8):e1024-e1028. doi: 10.1097/MAO.0000000000002722.
To evaluate OTOPLAN software in the surgical planning of far-advanced otosclerosis (FAO) candidates to cochlear implant (CI) were considered. We aimed to preliminarily investigate if this software could influence the electrode length choice, or predict surgical difficulties.
We reviewed the outcome of five consecutive FAO patients that underwent unilateral CI. OTOPLAN was used to evaluate preoperative computed tomography imaging. A comparison was made with historical data (eight FAO patients).
The mean cochlear duct length estimated by OTOPLAN was 32.4 mm. Evaluating OTOPLAN reconstructed images, we ruled out cochlear lumen fibrosis/ossification in three FAO patients and the longest electrodes according to cochlear dimensions were preferred. We disclosed fibrosis in the middle and apical turns of two patients. These findings allowed us to change surgical plans, choosing a shorter electrode (24 and 28 mm instead of 31 mm) to avoid incomplete insertion due to cochlear fibrosis. OTOPLAN reconstructed images identified preoperatively the two patients with round window niche ossification that required additional drilling during surgery. In the present series, we experienced no incomplete insertion. In two cases out of eight historical FAO patients, array insertion (24 mm) was incomplete. One years after unilateral CI, the mean speech reception threshold and disyllabic word recognition score of the five considered FAO patients were 36 dB and 94%, respectively (39 dB and 84% for the eight historical patients). There was no facial nerve stimulation or any other complication during the 1-year follow-up.
According to our preliminary results, OTOPLAN was useful for the appropriate choice of array length.
评估 OTOPLAN 软件在考虑进行人工耳蜗植入 (CI) 的晚期耳硬化症 (FAO) 患者手术规划中的作用。我们旨在初步研究该软件是否会影响电极长度的选择，或者预测手术难度。
我们回顾了 5 例连续接受单侧 CI 的 FAO 患者的结果。使用 OTOPLAN 评估术前 CT 成像。与历史数据（8 例 FAO 患者）进行比较。
OTOPLAN 估计的耳蜗管长度平均值为 32.4mm。评估 OTOPLAN 重建图像后，我们排除了 3 例 FAO 患者的耳蜗管内腔纤维化/骨化，并根据耳蜗尺寸选择了最长的电极。我们发现 2 例患者的中、尖转存在纤维化。这些发现使我们能够改变手术计划，选择更短的电极（24 和 28mm 而不是 31mm），以避免因耳蜗纤维化导致电极不完全插入。OTOPLAN 重建图像术前识别出 2 例圆窗龛骨化的患者，术中需要额外钻孔。在本系列中，我们没有遇到不完全插入的情况。在 8 例历史 FAO 患者中有 2 例出现了电极插入不完全的情况（24mm）。5 例考虑的 FAO 患者单侧 CI 后 1 年，平均言语接受阈值和双音节词识别得分分别为 36dB 和 94%（8 例历史患者为 39dB 和 84%）。在 1 年的随访中，没有面神经刺激或任何其他并发症。
根据我们的初步结果，OTOPLAN 有助于适当选择电极长度。
