Otolaryngology Department, Tanta University, Tanta, Egypt.
Otolaryngology Department, Kafrelsheikh University, Elgeeish Street, Kafrelsheikh, 33511, Egypt.
Eur Arch Otorhinolaryngol. 2022 Oct;279(10):4893-4898. doi: 10.1007/s00405-022-07334-6. Epub 2022 Mar 26.
This study aimed to validate our novel proposed radiological evaluation of the posterior tympanotomy (PT) depth. This dimension represents the bone of the facial recess needed to be drilled to get access into the middle ear during cochlear implantation.
It was a retrospective observational study that included 257 patients who underwent cochlear implantation from July 2018 to April 2021 in tertiary referral institutions. Two physicians evaluated the preoperative HRCT to measure the PT depth in the oblique para-sagittal cut. On the other hand, two other physicians evaluated the unedited surgical videos to judge the PT depth and classified it into an ordinary PT or deep PT. Then, the preoperative radiological measurements were correlated with the intraoperative findings.
The radiological PT depth ranged from 2.5 to 5.4 mm with a mean of 3.91 ± 0.886. Sixty-six patients had ordinary PT, and 191 patients had deep PT. Spearman's correlation coefficient revealed a strong correlation between the preoperative radiological PT depth measurements and the intraoperative PT depth judgments (p value < 0.0001).
We created a novel radiological method to measure the posterior tympanotomy depth. This method was valid, reproducible, and reliable in the preoperative radiological evaluation of the PT depth with high sensitivity (91.71%), specificity (90.62%), and accuracy (91.44%). We also found a significant impact of the PT depth on the PT difficulty during cochlear implantation.
本研究旨在验证我们新提出的用于评估后鼓室切开术（PT）深度的放射学方法。该维度代表了在进行人工耳蜗植入时需要钻取的面神经隐窝骨，以便进入中耳。
这是一项回顾性观察性研究，纳入了 2018 年 7 月至 2021 年 4 月在三级转诊机构接受人工耳蜗植入术的 257 例患者。两名医生评估了术前高分辨率 CT（HRCT），以测量斜矢状位切片上的 PT 深度。另一方面，另外两名医生评估了未经编辑的手术视频，以判断 PT 深度，并将其分为普通 PT 或深 PT。然后，将术前放射学测量值与术中发现进行相关性分析。
PT 深度的放射学范围为 2.5 至 5.4mm，平均值为 3.91±0.886mm。66 例患者为普通 PT，191 例患者为深 PT。Spearman 相关系数显示，术前放射学 PT 深度测量值与术中 PT 深度判断之间存在很强的相关性（p 值<0.0001）。
我们创建了一种新的放射学方法来测量后鼓室切开术深度。该方法在术前评估 PT 深度方面具有有效性、可重复性和可靠性，敏感性为 91.71%，特异性为 90.62%，准确性为 91.44%。我们还发现 PT 深度对人工耳蜗植入时 PT 难度有显著影响。
