Surgical Anatomy of the Human Round Window Region

Fujita, Takeshi; Shin, Jung Eun; Cunnane, Marybeth; Fujita, Kyoko; Henein, Simon; Stanković, Konstantina M.

doi:10.1097/mao.0000000000001074

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…32 or an angled endoscope as proposed by Fujita et al . 48 . For guided electrode insertion, it is more important to visualize the ST trajectory, along with its possible obstacles, than the individual intracochlear structures.…”

Section: Discussionmentioning

confidence: 99%

High-resolution Imaging of the Human Cochlea through the Round Window by means of Optical Coherence Tomography

Starovoyt

Putzeys

Wouters

et al. 2019

Sci Rep

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The human cochlea is deeply embedded in the temporal bone and surrounded by a thick otic capsule, rendering its internal structure inaccessible for direct visualization. Clinical imaging techniques fall short of their resolution for imaging of the intracochlear structures with sufficient detail. As a result, there is a lack of knowledge concerning best practice for intracochlear therapy placement, such as cochlear implantation. In the past decades, optical coherence tomography (OCT) has proven valuable for non-invasive, high-resolution, cross-sectional imaging of tissue microstructure in various fields of medicine, including ophthalmology, cardiology and dermatology. There is an upcoming interest for OCT imaging of the cochlea, which so far was mostly carried out in small animals. In this temporal bone study, we focused on high-resolution imaging of the human cochlea. The cochlea was approached through mastoidectomy and posterior tympanotomy, both standard surgical procedures. A commercially available spectral-domain OCT imaging system was used to obtain high-resolution images of the cochlear hook region through the intact round window membrane in four cadaveric human temporal bones. We discuss the qualitative and quantitative characteristics of intracochlear structures on OCT images and their importance for cochlear implant surgery.

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Section: Discussionmentioning

confidence: 99%

High-resolution Imaging of the Human Cochlea through the Round Window by means of Optical Coherence Tomography

Starovoyt

Putzeys

Wouters

et al. 2019

Sci Rep

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“…While significant development is required before this technology can be employed to assess cochlear pathology in living humans, the present study demonstrates μOCT’s potential to image this organ and motivates further miniaturization of μOCT technology. We have recently reported progress in the development of miniaturized μOCT instrumentation for in vivo applications 46 47 and in human cochlear endoscopy via the external auditory canal 48 . However, the adaptation of our imaging configuration to the constraints of the small size and embedded location of the human cochlea remains a significant technical challenge.…”

Section: Discussionmentioning

confidence: 99%

Micro-optical coherence tomography of the mammalian cochlea

Iyer

Batts

Chu

et al. 2016

Sci Rep

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The mammalian cochlea has historically resisted attempts at high-resolution, non-invasive imaging due to its small size, complex three-dimensional structure, and embedded location within the temporal bone. As a result, little is known about the relationship between an individual’s cochlear pathology and hearing function, and otologists must rely on physiological testing and imaging methods that offer limited resolution to obtain information about the inner ear prior to performing surgery. Micro-optical coherence tomography (μOCT) is a non-invasive, low-coherence interferometric imaging technique capable of resolving cellular-level anatomic structures. To determine whether μOCT is capable of resolving mammalian intracochlear anatomy, fixed guinea pig inner ears were imaged as whole temporal bones with cochlea in situ. Anatomical structures such as the tunnel of Corti, space of Nuel, modiolus, scalae, and cell groupings were visualized, in addition to individual cell types such as neuronal fibers, hair cells, and supporting cells. Visualization of these structures, via volumetrically-reconstructed image stacks and endoscopic perspective videos, represents an improvement over previous efforts using conventional OCT. These are the first μOCT images of mammalian cochlear anatomy, and they demonstrate μOCT’s potential utility as an imaging tool in otology research.

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“…Using an endoscope, it is now possible to directly enter into the round window niche via the external auditory canal in the majority of patients [76]. However, it is important to note that the real RWM is often obstructed by a pseudo-membrane in human temporal bones [77]. Therefore, in future translational studies focusing on cochlear viral-mediated gene administration, it is important to make sure that the entire RWM is in contact with a therapeutic solution after removal of the pseudo-membrane.…”

Section: Round-window Membrane Diffusionmentioning

confidence: 99%

rAAV-Mediated Cochlear Gene Therapy: Prospects and Challenges for Clinical Application

Blanc

Mondain

Bemelmans

et al. 2020

JCM

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Over the last decade, pioneering molecular gene therapy for inner-ear disorders have achieved experimental hearing improvements after a single local or systemic injection of adeno-associated, virus-derived vectors (rAAV for recombinant AAV) encoding an extra copy of a normal gene, or ribozymes used to modify a genome. These results hold promise for treating congenital or later-onset hearing loss resulting from monogenic disorders with gene therapy approaches in patients. In this review, we summarize the current state of rAAV-mediated inner-ear gene therapies including the choice of vectors and delivery routes, and discuss the prospects and obstacles for the future development of efficient clinical rAAV-mediated cochlear gene medicine therapy.

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Surgical Anatomy of the Human Round Window Region

Cited by 18 publications

References 23 publications

High-resolution Imaging of the Human Cochlea through the Round Window by means of Optical Coherence Tomography

High-resolution Imaging of the Human Cochlea through the Round Window by means of Optical Coherence Tomography

Micro-optical coherence tomography of the mammalian cochlea

rAAV-Mediated Cochlear Gene Therapy: Prospects and Challenges for Clinical Application

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