Diagnostic and Interventional Radiology Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Egypt.
Cochlear Implant Unit, Mansoura University Hospital, Otolaryngology Department, Faculty of Medicine, Mansoura University, Egypt.
Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110521. doi: 10.1016/j.ijporl.2020.110521. Epub 2020 Nov 26.
To evaluate the add value of combined analysis of high resolution computed tomography (HRCT) temporal bone parameters in accurate prediction of round window (RW) visibility through posterior tympanotomy.
a retrospective observational study was held in a tertiary center, conducted on 45 cochlear implant pediatric candidates between January 2017 and September 2019. Candidates were referred for CT temporal bone. They were classified into fully visible RW cases and partially or non-visible RW cases. Radiological measurements were compared between the two groups for prediction of RW visibility separate and in combination.
45 patients were included in the study (26 males (57.8%) and 19 females (42.2%)). Their median age was 4 years (2-12 years). There were 38 (84.4%) fully visible and 7 (15.6%) partially or non-visible RW cases. Kashio posterior line (n:32/3), fascial recess width (FRW) (mean: 4.9 (3.5-7.5)/4.2 (4-4.7) mm) and round window location (RWL) (3 (1-4)/2.8 (1-3)mm) measurements significantly differentiated between the two groups; (P value 0.034, 0.012 & 0.025 respectively). Posterior kashio line and cut off values of ≥4.75 mm of FRW & 2.95 mm of RWL were showed sensitivity 84.2%, 63.2% & 65.8%, and accuracy 80%, 68.9% &68.9% in prediction of RW visibility respectively. Combination of Kashio prediction line with cut off value ≥ 7.45 mm (sum of FRW & RWL) showed P value 0.003 with further improve in the sensitivity and overall accuracy in prediction of RW visibility from 84.2% to 80% up to 91.4% and 88.6% respectively.
combined parameters using Kashio line with FRW and RWL increases sensitivity and overall accuracy in prediction of RW visibility rather than single parameter.
评估高分辨率 CT（HRCT）颞骨参数联合分析在经后鼓室径路预测圆窗（RW）可视性方面的附加价值。
这是一项在三级中心进行的回顾性观察研究，纳入了 2017 年 1 月至 2019 年 9 月期间的 45 例人工耳蜗植入候选儿童患者。所有患者均转诊进行 CT 颞骨检查，根据 RW 是否完全可见分为完全可见组和部分或不可见组。比较两组患者的影像学测量值，以单独和联合预测 RW 的可视性。
研究纳入了 45 例患者（男 26 例[57.8%]，女 19 例[42.2%]），中位年龄为 4 岁（2-12 岁）。38 例患者 RW 完全可见，7 例患者 RW 部分或不可见。Kashio 后线（n=32/3）、筋膜隐窝宽度（FRW）（均值：4.9（3.5-7.5）/4.2（4-4.7）mm）和 RW 位置（RWL）（3（1-4）/2.8（1-3）mm）测量值在两组间存在显著差异（P 值分别为 0.034、0.012 和 0.025）。Kashio 后线和 FRW 截断值≥4.75mm 及 RWL 截断值≥2.95mm 对 RW 可视性的预测具有 84.2%、63.2%和 65.8%的敏感性和 80%、68.9%和 68.9%的准确性。Kashio 预测线与截断值≥7.45mm（FRW 和 RWL 之和）联合使用，预测 RW 可视性的敏感性和总体准确性进一步提高，从 84.2%分别提高至 80%和 91.4%和 88.6%。
Kashio 线与 FRW 和 RWL 联合参数的使用可提高预测 RW 可视性的敏感性和总体准确性，而非单一参数。
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