Analysis of intersubject variations in intracochlear and middle ear surface anatomy for cochlear implantation.
Analysis of intersubject variations in intracochlear and middle ear surface anatomy for cochlear implantation.
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DOI：
10.1097/mao.0b013e3182a1a7e6
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Labadie RF
中科院分区：
文献类型：
--
作者：
Pelosi S;Noble JH;Dawant BM;Labadie RF
We hypothesize that surface landmarks surrounding the round window typically used to guide electrode placement during cochlear implantation (CI) exhibit substantial variability with respect to intracochlear anatomy. Recent publications suggest that both atraumatic electrode insertion and electrode location within the scala tympani can affect auditory performance after CI. However, current techniques for electrode insertion rely on surface landmarks alone for navigation, without actual visualization of intracochlear structures other than what can be seen through a surgically-created cochleostomy. In this study we quantify how well the position of intracochlear anatomy is predicted by surface landmarks surrounding the round window. Structures representing middle ear surface and intracochlear anatomy were reconstructed in μCT scans of 10 temporal bone specimens. These structures were then re-oriented into a normalized coordinate system to facilitate measurement of inter-subject anatomical shape variations. Only minor inter-subject variations were detected for intracochlear anatomy (maximum deviation = 0.71 mm, standard deviation = 0.21 mm), with greatest differences existing near the hook and apex. Larger inter-subject variations in intracochlear structures were detected when considered relative to surface landmarks surrounding the round window (maximum deviation = 0.83 mm, standard deviation = 0.54 mm). The cochlea and its scala exhibit considerable variability in relation to middle ear surface landmarks. While support for more precise, atraumatic CI electrode insertion techniques is growing in the otologic community, landmark guided insertion techniques have limited precision. Refining the CI insertion process may require the development of image-guidance systems for use in otologic surgery.
