Karagoz Yesim, Ertugay Cigdem Kalaycik, Aksoy Direnç Özlem, Mahmutoglu Ozdes, Mahmutoglu Abdullah Soydan
Department of Radiology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Otorhinolaryngology, Acıbadem Kozyatagi Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2025 Jun;282(6):2927-2937. doi: 10.1007/s00405-024-09162-2. Epub 2025 Jan 3.
Cochlear implantation (CI) surgery is essential for restoring hearing in individuals with severe sensorineural hearing loss. Accurate placement of the electrode within the cochlea is essential for successful auditory outcomes and minimizing complications. This study aims to analyze the relationship between the round window niche (RWN) alignment, its visibility during surgery, and the impact on surgical techniques and outcomes.
A retrospective study was conducted, examining high-resolution computed tomography (CT) scans of the temporal bone from 103 patients who underwent CI. RWN visibility was assessed using the St. Thomas Hospital (STH) classification. Anatomical parameters such as the angles of RWN alignment relative to the lateral semicircular canal (LSCC) plane and the distances to the facial nerve were measured and recorded.
The analysis revealed that RWN alignment angles did not significantly correlate with RWN visibility. However, specific anatomical distances, such as the anteroposterior distance between the round window membrane (RWM) and the facial nerve, were significantly associated with improved RWN visibility.
Preoperative knowledge of RWN anatomy, particularly its relationship with the facial nerve, can reduce the complexity of CI surgery. Understanding these anatomical variations is essential for optimizing surgical outcomes. Future research should explore additional cochlear axis orientations to enhance surgical techniques and improve visibility assessments during CI procedures.
人工耳蜗植入（CI）手术对于重度感音神经性听力损失患者恢复听力至关重要。电极在耳蜗内的精确放置对于获得成功的听觉效果和减少并发症至关重要。本研究旨在分析圆窗龛（RWN）的对线情况、其在手术中的可视性以及对手术技术和结果的影响之间的关系。
进行了一项回顾性研究，检查了103例接受CI手术患者的颞骨高分辨率计算机断层扫描（CT）。使用圣托马斯医院（STH）分类法评估RWN的可视性。测量并记录了诸如RWN相对于外侧半规管（LSCC）平面的对线角度以及到面神经的距离等解剖学参数。
分析显示，RWN对线角度与RWN可视性无显著相关性。然而，特定的解剖学距离，如圆窗膜（RWM）与面神经之间的前后距离，与RWN可视性的改善显著相关。
术前了解RWN的解剖结构，特别是其与面神经的关系，可以降低CI手术的复杂性。了解这些解剖变异对于优化手术结果至关重要。未来的研究应探索额外的耳蜗轴方向，以改进手术技术并改善CI手术过程中的可视性评估。
