Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Panda, Naresh K.

doi:10.15406/joentr.2017.08.00263

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Several studies have been done to classify the RWN and RWM visibility via the facial recess approach. 6,7 In our study, RWN with different levels of visibility had a varied distribution amongst both groups, however, Type A RWN (not visible) was only encountered in the adult population. RWM visibility, on the contrary, had a different picture.…”

Section: Discussioncontrasting

confidence: 44%

“…Their study, however, didn't specify the age group. 6 Dalmia et al in their study, used a different classification for grading RWM visibility in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…Round window membrane (RWM) visibility was classified as follows: 6 • Grade I : >50% of RWM is visible • Grade II : 25%-50% of RWM is visible • Grade III : <25% of RWM is visible • Grade IV : RWM is not visible Round window niche (RWN) visibility was classified as follows: 7…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery

Pradhananga

Gyawali

Rayamajhi

2020

Journal of Institute of Medicine

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Introduction The round window is thought to be an ideal port for inserting electrodes during cochlear implantation. Considering its complex anatomy with an individual variation, this study aims to review the anatomy of round window based on the visibility of round window niche and round window membrane via posterior tympanotomy in pediatric and adult population who underwent cochlear implantation. MethodsThis was a retrospective observational study conducted at the Department of ENT-HNS, Institute of Medicine, Kathmandu, Nepal. Surgical notes of adult (>15 years) and pediatric cases (<15years) who underwent primary cochlear implantation from January 2015 to January 2018 were assessed for different grading of round window niche and round window membrane visibility via posterior tympanotomy. Cases with revision surgery and with incomplete documentation of intra-operative findings were excluded from the study. Statistical analysis was done using SPSS software version 25. We used Chi-square and Fisher’s exact tests to analyze the statistical association. ResultsType B round window niche (partially visible) was the most common variant seen in the pediatric group while in adults, both Type B (partially visible) and Type C (fully visible) round window niche were common. Compared to the adults, the pediatric group had good visibility of RWM. However, there was no statistical association between these observations. ConclusionThe round window has a wide range of anatomical variations with different levels of visibility of RWN and RWM in the different age groups. Although statistically insignificant, RWM visibility seemed to be better in pediatric cases compared to adults.

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Section: Discussioncontrasting

confidence: 44%

“…Their study, however, didn't specify the age group. 6 Dalmia et al in their study, used a different classification for grading RWM visibility in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery

Pradhananga

Gyawali

Rayamajhi

2020

Journal of Institute of Medicine

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“…The anterolateral displaced facial nerve always considered the limiting point for appropriate wide facial recess even with experienced surgeons that require using small diameter endoscopy 1.9mm,0degree thought posterior tympanotomy to give panoramic very clear identification of round window to be sure about the exact site of the round window. 5 The round window niche is considered one of the covered areas that the endoscope can precisely recognize and discriminate it from the hypotympanic structure and Subcochlear Canaliculus ( Figure 4 ). These pros help to decrease complications and allow atraumatic electrode insertion in the scala tympani for hearing conservation.…”

Section: Discussionmentioning

confidence: 99%

The Value of Endoscopic Exposure of Round Window in Cochlear Implant via Facial Recess

Nassif,

Darahem,

Teaima

et al. 2024

Int Arch Otorhinolaryngol

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Introduction Cochlear implantation has been considered as the best treatment in patients with severe to profound hearing loss unaidable with hearing aids. The main value of endoscope-assisted cochlear implantation is improved visibility of the RW Objective to assess the value of endoscopic assisted CI surgery via facial recess approach without elevating tympanic anulus. Methods This Prospective case series study non-randomized sample was performed on 50 patients with severe to profound hearing loss unaidable with hearing aids undergoing unilateral endoscopic assisted cochlear implant surgery with round window electrode insertion Results There were 23 male and 27 female patients. Most of the cases were children (41 cases). Of those 50 patients, 39 were prelingually hearing impaired. Four cases had various inner ear abnormalities. The standard mastoidectomy and Posterior Tympanotomy approach were used for all cases. Endoscopic identification of the RW through the PT enabled us to perform regular surgery in all cases. The current study concludes the difference between microscopic exposure and endoscopic exposure represented by Saint Tomas classification found that endoscopic exposure of round window classification is better represented by downgrading in the classification of round window exposure as type I 29(58%), type IIa 18(36%) type IIb 3 (6%) Non were type III by endoscopic exposure compared to microscopic exposure of round window is a type I 7(14%), type II 14(28%), type IIb 22(44%) and type III 7 (14%). Conclusion Endoscopy proved a great value in exposure and identification of RW in CI surgery through posterior tympanotomy approach,

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“…During cochlear implant (CI), mastoidectomy with facial recess approach is the gold standard approach [1]. The limitation of such approach includes the difficulty in round window orientation in some cases for example narrowed posterior tympanotomy or contacted mastoid [2,3].…”

Section: Introductionmentioning

confidence: 99%

Role of Endoscopy in Round Window Identification during Cochlear Implant

Fouad¹,

Erfan²,

Hamed³

et al. 2020

JAMMR

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Aim: To access the usage of the endoscopy in round window (RW) orientation during cochlear implant (CI). Methodology: This was a retrospective case series study done in Otolaryngology Department, Tanta University, Egypt in 2018 and 2019. Inclusion criterion was all cases with CI surgery in which the endoscopy was used to locate the round window (RW) when this was difficult through the transmastoid approach. Results: The total cohort consisted of 13 CI patients in which endoscopy was used. Age mean was 35.5 years. Situations necessitating the usage of endoscope were: 6/13 with cochlear rotation, 4/13 with very narrow mastoid cavity, and 3/13 with narrow facial recess. By using the endoscope, the RW was fully visualized in all patients and CI insertion done through it. Conclusion: The endoscopy was of great value in some difficult CI cases.

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Evaluation of Round Window Accessibility for Electrode Insertion: Validation Study from two Centers

Cited by 8 publications

References 19 publications

Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery

Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery

The Value of Endoscopic Exposure of Round Window in Cochlear Implant via Facial Recess

Role of Endoscopy in Round Window Identification during Cochlear Implant

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