Department of Otorhinolaryngology, Ain Shams University Faculty of Medicine, Cairo, Egypt.
J Int Adv Otol. 2022 May;18(3):210-213. doi: 10.5152/iao.2022.21435.
This study aimed to evaluate the role of landmarks for proper round window electrode insertion in cochlear implantation surgery.
This is a case series study. We included 150 patients undergoing cochlear implantation in a tertiary medical center during the period from January to December 2019. Patients with inner ear malformations or ossification or revision surgery were excluded. Three surgeons partici- pated in the study. During surgery, the round window electrode insertion was marked using 5 surgical landmarks: oval window, pyramid, fustis, round window membrane, and arborization of intracochlear blood vessels. Each surgeon reported on the identification of each landmark and its reliability for round window electrode insertion.
Oval window and round window membrane were clearly seen by the 3 surgeons in all cases. Pyramid was seen in 94% of cases, fustis in 85%, and intracochlear wall in 90% of cases. The postoperative transorbital x-ray confirmed the intracochlear position of electrodes in all cases.
Round window electrode insertion can be precisely performed using these 5 surgical landmarks in straight forwards cases as well as in difficult cases. These landmarks can also assist in teaching young surgeons, in a step-wise manner, how to properly do round window electrode insertion in cochlear implantation surgery.
本研究旨在评估在人工耳蜗植入手术中使用标志点来正确插入圆窗电极的作用。
这是一项病例系列研究。我们纳入了 2019 年 1 月至 12 月期间在一家三级医学中心接受人工耳蜗植入术的 150 例患者。排除内耳畸形、骨化或翻修手术的患者。有 3 位外科医生参与了这项研究。在手术过程中，使用 5 个手术标志点标记圆窗电极插入部位：卵圆窗、锥体、鼓阶、圆窗膜和耳蜗内血管分支。每位外科医生报告了每个标志点的识别情况及其对圆窗电极插入的可靠性。
在所有病例中，3 位外科医生均能清楚地看到卵圆窗和圆窗膜。锥体在 94%的病例中可见，鼓阶在 85%的病例中可见，耳蜗内壁在 90%的病例中可见。术后经眶位 X 线片证实所有病例电极均位于耳蜗内。
在直入式病例和困难病例中，使用这 5 个手术标志点可以精确地进行圆窗电极插入。这些标志点还可以分步骤协助年轻外科医生正确进行人工耳蜗植入手术中的圆窗电极插入。
