Department of Otorhinolaryngology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Eur Arch Otorhinolaryngol. 2023 Apr;280(4):1647-1651. doi: 10.1007/s00405-022-07639-6. Epub 2022 Sep 8.
The objective of the study was to evaluate the proposed cochlear duct length estimation based on the cochlear 'A value'. Furthermore, we assessed the interobserver variability between radiology and otolaryngology attending physicians and otolaryngology trainees.
Thirteen pediatric cochlear implant candidates were retrospectively analyzed by three otolaryngology physicians (attending physician, second year, and fourth year trainees) and a radiology attending. The cochlear duct length was calculated based on the formula of Grover et al. The differences in acquired measurements between observers were compared using the Wilcoxon matched signed-rank test.
The differences in measurements between the attending otolaryngologist and radiologist were not statistically different, while several significant differences were observed with regard to measurements of attending doctors compared to both residents. In particular, a significant difference between the second year otolaryngology resident and otolaryngology and radiology attending was observed for one side (right ear p = 0.034 and p = 0.012, respectively). Moreover, the fourth year resident calculated significantly different cochlear duct measurements when compared to the attending otolaryngologist (left ear p = 0.014) and radiologist (right ear p = 0.047). Interestingly, differently experienced otolaryngology residents provided significantly different measurements for both ears.
Based on these results, cochlear duct length measurement according to the proposed method may be a reliable and cost-effective method. Indeed, otolaryngology training may be sufficient to provide measurements comparable to radiologists. On the other hand, additional efforts should be invested during otolaryngology training in terms of the evaluation of radiological imaging which may increase the capabilities of otolaryngology residents in this regard.
本研究旨在评估基于耳蜗“A 值”的耳蜗管长度估算方法，并评估放射科医师和耳鼻喉科住院医师及耳鼻喉科受训者之间的观察者间变异性。
对 13 名儿童耳蜗植入候选者进行回顾性分析，由 3 名耳鼻喉科医师（主治医生、第二年住院医生和第四年住院医生）和 1 名放射科主治医生进行分析。耳蜗管长度根据 Grover 等人的公式进行计算。使用 Wilcoxon 配对符号秩检验比较观察者之间获得的测量值差异。
耳鼻喉科主治医生和放射科医生的测量值之间差异无统计学意义，而与主治医生的测量值相比，住院医生的测量值存在几个显著差异。特别是，第二年耳鼻喉科住院医生与耳鼻喉科和放射科主治医生的一侧测量值存在显著差异（右侧耳 p=0.034 和 p=0.012）。此外，与耳鼻喉科主治医生（左耳 p=0.014）和放射科医生（右耳 p=0.047）相比，第四年住院医生计算的耳蜗管测量值也存在显著差异。有趣的是，不同经验水平的耳鼻喉科住院医生为双耳提供了显著不同的测量值。
基于这些结果，根据提出的方法测量耳蜗管长度可能是一种可靠且具有成本效益的方法。实际上，耳鼻喉科培训可能足以提供与放射科医生可比的测量值。另一方面，在耳鼻喉科培训期间，应在评估放射影像学方面投入额外的努力，这可能会提高耳鼻喉科住院医生在这方面的能力。
