Comparative evaluation of round window niche accessibility pre-operatively on high-resolution computed tomography of the temporal bone with intra-operative findings

Sharma, Raman; Meher, Ravi; Passey, Jigyasa; Kumar, Jyoti; Gupta, Abhishek; Kharbanda, Sandhya

doi:10.1017/s0022215119001269

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Endoscopic Cochlear Implantation Cochlear implantation is one of the new applications of endoscopes in the field of otology, but there are few case series on this topic. In a recent study, Sharma et al 28 concluded that the visualization of the round window niche improved with the use of an otoendoscope with 1.9 mm in diameter for cochleostomy and insertion of the electrode; a similar conclusion was reached in the study by Jain A et al 29…”

Section: The Ability To Visualize Past the Shaft Of Larger Surgicalmentioning

confidence: 60%

Acceptance of Endoscopes in Otology – An Indian Perspective and Review of the Literature

Sharma

Meher

Wadhwa

et al. 2023

Int Arch Otorhinolaryngol

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Introduction The role of endoscopes in the ear, nose, and throat (ENT) field has been described since the 1980s; It started with endoscopic nasal surgeries, followed by otological and laryngological procedures, and, since then, it has experienced a rapid evolution. Endoscopes help otologists understand how to approach difficult areas of middle ear, as well as the physiology of middle ear cleft. Objectives Despite the introduction of endoscopes in the field of otology, microscopes are still widely used in clinics and in operation theaters either alone or with endoscopes. The present study, which was conducted amongst otologists in India, is on their experience with and knowledge of the use of the endoscope compared to microscopes. Materials and Methods A Google form-based questionnaire comprising 18 questions was developed and sent online to otologist all over the country. The final dataset included responses from 354 active otologists. Results Out of 354 participants, only 3% had more than 5 years of experience in endoscopic ear surgery (EES), and 16.1% had never worked with an endoscope. Endoscopes were used in clinics and in operation theaters by 74.9% of the participants. Conclusion There has been a rise in the acceptance and use of endoscopes among Indian otologists and otology surgeons in last few decades.

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Section: The Ability To Visualize Past the Shaft Of Larger Surgicalmentioning

confidence: 60%

Acceptance of Endoscopes in Otology – An Indian Perspective and Review of the Literature

Sharma

Meher

Wadhwa

et al. 2023

Int Arch Otorhinolaryngol

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“…How can we evaluate RWNV by noninvasive measurement? Previous inner ear imaging studies mostly focused on the measurement of the round window niche (RWN) and its position relationship with adjacent structures (such as the cochlear basal turn and facial nerve) to assess its impact on cochlear implantation, [18][19][20][21][22][23][24][25] but little attention had been paid to the existence of RWNV and its possible clinical effects.…”

Section: Introductionmentioning

confidence: 99%

Round Window Niche Veil is Visible on High‐Resolution Computed Tomography and a Predictor of Local Drug Efficacy to Inner Ear

Zhuo,

Li,

Cui

et al. 2023

The Laryngoscope

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ObjectivesTo determine the morphologies and effect of the round window niche veil (RWNV) on local drug delivery efficacy and develop diagnostic criteria on high‐resolution computed tomography (HRCT).MethodsPatients diagnosed with otosclerosis, bilateral profound sensorineural hearing loss or vestibular schwannoma were enrolled from 2019 to 2022, receiving temporal bone HRCT scanning, and anatomic variations of RWMV were summarized intraoperative. For patients with vestibular schwannoma, 1 mL of dexamethasone solution (4 mg/mL) was administered via facial recess during operation, and samples of perilymph were collected to analyze. The diagnostic criteria of RWNV on HRCT were developed and verified.ResultsA total of 85 patients were enrolled. RWNV was observed in 54 cases intraoperatively with an incidence of 63.5% (95% CI, 52.9%–73.0%). The median perilymph concentrations were 4.86‐fold higher in the group without RWNV than with RWNV (p < 0.0001). RWNV could be visualized on HRCT with a window width of 3500–4500 HU and a window level of 300–500 HU. The characteristic features were as follows: (1) a thin soft tissue shadow could be seen at the entrance of the round window niche (RWN); (2) it was visible in at least 2 consecutive layers along the upper margin of RWN from top to bottom; (3) it was discontinuous with the adjacent bone margin. The sensitivity and specificity of the diagnostic criteria were 77.8% and 93.6%, respectively.ConclusionRWNV could reduce local dexamethasone diffusion efficacy to the inner ear, which could be diagnosed on HRCT and used as a predictor of local drug delivery efficacy to the inner ear.Level of Evidence3 Laryngoscope, 2023

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“…Pathologies of the middle and inner ear, such as malformations, inflammation, trauma and especially cancer can be assessed precisely for preoperative planning [1]. High positive and negative predictive values of up to 91% for intraoperative findings involving middle ear structures-i.e., ossicles or the round window-as well as the extent of cholesteatoma and neoplasms have been described in earlier studies on high-resolution CTs of the temporal bone [2][3][4][5]. Otologic surgeons, therefore, prefer high-resolution CTs to avoid image noise and the blurred visualization of subtle temporal bone structures.…”

Section: Introductionmentioning

confidence: 99%

ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols

et al. 2021

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Objective: Repeated computed tomography (CT) is essential for diagnosis, surgical planning and follow-up in patients with middle and inner ear pathology. Dose reduction to “as low as diagnostically acceptable” (ALADA) is preferable but challenging. We aimed to compare the diagnostic quality of images of subtle temporal bone structures produced with low doses (LD) and reference protocols (RP). Methods: Two formalin-fixed human cadaver heads were scanned using a 64-slice CT scanner and cone-beam CT (CBCT). The protocols were: RP (120 kV, 250 mA, CTDIvol 83.72 mGy), LD1 (100 kV, 80 mA, CTDIvol 26.79 mGy), LD2 (100 kV, 35 mA, CTDIvol 7.66 mGy), LD3 (80 kV, 40 mA, CTDIvol 4.82 mGy), and CBCT standard protocol. Temporal bone structures were assessed using a 5-point scale. Results: A median score of ≥2 was achieved with protocols such as the tendons of m. tensor tympani (RP/LD1/LD2/CBCT) and m. stapedius (CBCT), the incudostapedial joint (RP/LD1/CBCT), the incudomalleolar joint (RP/LD1/LD2/CBCT), the stapes feet (RP/LD1/CBCT), the stapes head (RP/LD1/LD2/CBCT), the tympanic membrane (RP/LD1/LD2/CBCT), the lamina spiralis ossea (none), the chorda tympani (RP/LD1/CBCT), and the modiolus (RP/LD1/LD2/CBCT). Adaptive statistical iterative reconstructions did not show advantages over the filtered back projection. Conclusions: LD protocols using a CTDIvol of 7.66 mGy may be sufficient for the identification of temporal bone structures.

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Comparative evaluation of round window niche accessibility pre-operatively on high-resolution computed tomography of the temporal bone with intra-operative findings

Cited by 9 publications

References 16 publications

Acceptance of Endoscopes in Otology – An Indian Perspective and Review of the Literature

Acceptance of Endoscopes in Otology – An Indian Perspective and Review of the Literature

Round Window Niche Veil is Visible on High‐Resolution Computed Tomography and a Predictor of Local Drug Efficacy to Inner Ear

ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols

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