The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study

Objective: To evaluate incidence of interscalar excursions between round window (RW) and cochleostomyÂ approaches for cochlear implant (CI) insertion. Methods: This was a retrospective case-comparison. Flat-panel CT (FPCT) scans for 8 CI users with Med-El standard length electrode arrays were collec...

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Autores principales:	Nicole T. Jiam, Charles J. Limb
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2016
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/20af145b412846a180c2e9290ce9a2da
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spelling	oai:doaj.org-article:20af145b412846a180c2e9290ce9a2da2021-12-02T14:39:14ZThe impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study2095-881110.1016/j.wjorl.2016.07.001https://doaj.org/article/20af145b412846a180c2e9290ce9a2da2016-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881116300427https://doaj.org/toc/2095-8811Objective: To evaluate incidence of interscalar excursions between round window (RW) and cochleostomyÂ approaches for cochlear implant (CI) insertion. Methods: This was a retrospective case-comparison. Flat-panel CT (FPCT) scans for 8 CI users with Med-El standard length electrode arrays were collected. Surgical technique was identified by a combination of operative notes and FPCT imaging. Four cochleae underwent round window insertion and 4 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Results: In our pilot study, cochleostomy approaches were associated with a higher likelihood of interscalar excursion. Within the cochleostomy group, we found 29% of electrode contacts (14 of 48 electrodes) to be outside the scala tympani. On the other hand, 8.5% of the electrode contacts (4 of 47 electrodes) in the round window insertion group were extra-scalar to the scala tympani. These displacements occurred at a mean angle of occurrence of 364Â°Â Â±Â 133Â°, near the apex of the cochlea. Round window electrode displacements tend to localize at angle of occurrences of 400Â° or greater. Cochleostomy electrodes occurred at an angle of occurrence of 19Â°â490Â°. Conclusions: Currently, the optimal surgical approach for standard CI electrode insertion is highly debated, to a certain extent due to a lack of post-operative assessment of intracochlear electrode contact. Based on our preliminary findings, cochleostomy approach is associated with an increased likelihood of interscalar excursions, and these findings should be further evaluated with future prospective studies. Keywords: Cochlear implantation, Round window insertion, Cochleostomy, Interscalar excursion, Electrode position, Flat-panel computed tomography, Surgical approachNicole T. JiamCharles J. LimbKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 2, Iss 3, Pp 142-147 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Nicole T. Jiam Charles J. Limb The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
description	Objective: To evaluate incidence of interscalar excursions between round window (RW) and cochleostomyÂ approaches for cochlear implant (CI) insertion. Methods: This was a retrospective case-comparison. Flat-panel CT (FPCT) scans for 8 CI users with Med-El standard length electrode arrays were collected. Surgical technique was identified by a combination of operative notes and FPCT imaging. Four cochleae underwent round window insertion and 4 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Results: In our pilot study, cochleostomy approaches were associated with a higher likelihood of interscalar excursion. Within the cochleostomy group, we found 29% of electrode contacts (14 of 48 electrodes) to be outside the scala tympani. On the other hand, 8.5% of the electrode contacts (4 of 47 electrodes) in the round window insertion group were extra-scalar to the scala tympani. These displacements occurred at a mean angle of occurrence of 364Â°Â Â±Â 133Â°, near the apex of the cochlea. Round window electrode displacements tend to localize at angle of occurrences of 400Â° or greater. Cochleostomy electrodes occurred at an angle of occurrence of 19Â°â490Â°. Conclusions: Currently, the optimal surgical approach for standard CI electrode insertion is highly debated, to a certain extent due to a lack of post-operative assessment of intracochlear electrode contact. Based on our preliminary findings, cochleostomy approach is associated with an increased likelihood of interscalar excursions, and these findings should be further evaluated with future prospective studies. Keywords: Cochlear implantation, Round window insertion, Cochleostomy, Interscalar excursion, Electrode position, Flat-panel computed tomography, Surgical approach
format	article
author	Nicole T. Jiam Charles J. Limb
author_facet	Nicole T. Jiam Charles J. Limb
author_sort	Nicole T. Jiam
title	The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
title_short	The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
title_full	The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
title_fullStr	The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
title_full_unstemmed	The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study
title_sort	impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: preliminary results from a flat-panel computed tomography study
publisher	KeAi Communications Co., Ltd.
publishDate	2016
url	https://doaj.org/article/20af145b412846a180c2e9290ce9a2da
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The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study

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