Abstract：
OBJECTIVE: The aim of this study was to determine optimal radiological parameters for assessment of the round window approach in cochlear implantation surgery.
METHODS: Patients undergoing cochlear implantation at the Department of Otolaryngology in Szczecin, between 2015 and 2022 inclusive, were eligible for the study. Radiological assessments were performed according to eight parameters (seven proposed in the literature) and visibility clinical assessments were made intra-operatively on a scale of 1 to 5 (1 - not visible, 5 - fully visible). Visibility assessments of the round window niche (RWN) and round window membrane (RWM) allowed the difference (RWN minus RWM) to be used as a clinical assessment of the size of the overhang over the round window.
RESULTS: Computed tomography images of 57 ears from 52 patients were analyzed in terms of round window access. The study group included 26 females and 26 males, ranging in age from 1 year to 80 years, with a median age of 41 years. In clinical assessment, round window visibility was rated as 5, after removal of the bone overhang, in 69% of patients. Cochlear access through the round window was achieved in 39 (68%) cases, extended access through the round window in 13 (23%) cases and cochleostomy was performed in 5 (9%) cases. Statistically significant ordinal correlations with round-window access were found using one parameter from the literature (Chen_Angle) and from our proposal (RWM_prediction). From parameters describing the bone overhang of the round window, positive correlations (using Kendall rank tests) were found using parameters from the literature (Sarafraz_OH and Mehanna_OH).
CONCLUSIONS: Radiological measurements describing access to the round window which determine the angle based on the anatomy of the posterior wall of the auditory canal and the position of the facial nerve were found to be of the highest value.
CONCLUSIONS: In the future, the use of algorithms for computed tomography evaluation and robot-assisted surgery will require parameters for assessing round window access, for surgery planning and choice of electrode. The parameters proposed by various authors are summarized, allowing researchers to assess their usefulness in further clinical practice.
METHODS: Patients undergoing cochlear implantation at the Department of Otolaryngology in Szczecin, between 2015 and 2022 inclusive, were eligible for the study. Radiological assessments were performed according to eight parameters (seven proposed in the literature) and visibility clinical assessments were made intra-operatively on a scale of 1 to 5 (1 - not visible, 5 - fully visible). Visibility assessments of the round window niche (RWN) and round window membrane (RWM) allowed the difference (RWN minus RWM) to be used as a clinical assessment of the size of the overhang over the round window.
RESULTS: Computed tomography images of 57 ears from 52 patients were analyzed in terms of round window access. The study group included 26 females and 26 males, ranging in age from 1 year to 80 years, with a median age of 41 years. In clinical assessment, round window visibility was rated as 5, after removal of the bone overhang, in 69% of patients. Cochlear access through the round window was achieved in 39 (68%) cases, extended access through the round window in 13 (23%) cases and cochleostomy was performed in 5 (9%) cases. Statistically significant ordinal correlations with round-window access were found using one parameter from the literature (Chen_Angle) and from our proposal (RWM_prediction). From parameters describing the bone overhang of the round window, positive correlations (using Kendall rank tests) were found using parameters from the literature (Sarafraz_OH and Mehanna_OH).
CONCLUSIONS: Radiological measurements describing access to the round window which determine the angle based on the anatomy of the posterior wall of the auditory canal and the position of the facial nerve were found to be of the highest value.
CONCLUSIONS: In the future, the use of algorithms for computed tomography evaluation and robot-assisted surgery will require parameters for assessing round window access, for surgery planning and choice of electrode. The parameters proposed by various authors are summarized, allowing researchers to assess their usefulness in further clinical practice.
摘要：
目的：本研究的目的是确定最佳的放射学参数，以评估耳蜗植入手术中的圆窗入路。
方法：在Szczecin耳鼻喉科接受人工耳蜗植入的患者，在2015年至2022年期间，有资格参加这项研究。根据八个参数（文献中提出的七个）进行放射学评估，并在术中进行可见性临床评估，量表为1至5（1-不可见，5-完全可见）。圆窗生态位（RWN）和圆窗膜（RWM）的可见性评估允许将差异（RWN减去RWM）用作圆窗上方悬垂尺寸的临床评估。
结果：对52例患者57耳的计算机断层扫描图像进行了圆窗入路分析。研究组包括26名女性和26名男性，年龄从1岁到80岁不等，平均年龄为41岁。在临床评估中，圆窗能见度为5，去除骨悬垂后，69%的患者。在39例(68%)病例中，通过圆窗进入耳蜗，13例（23％）通过圆窗延伸进入，5例（9％）进行了耳蜗造口术。使用文献（Chen_Angle）和我们的建议（RWM_prediction）中的一个参数，发现了与圆窗访问具有统计学意义的序数相关性。从描述圆窗骨悬垂的参数来看，使用文献中的参数（Sarafraz_OH和Mehanna_OH）发现了正相关（使用Kendall秩检验）。
结论：根据耳道后壁的解剖结构和面神经的位置，描述进入圆窗的放射学测量值最高。
结论：在未来，使用算法进行计算机断层扫描评估和机器人辅助手术将需要参数来评估圆窗通道，用于手术计划和电极的选择。总结了各种作者提出的参数，允许研究人员评估其在进一步临床实践中的有用性。
方法：在Szczecin耳鼻喉科接受人工耳蜗植入的患者，在2015年至2022年期间，有资格参加这项研究。根据八个参数（文献中提出的七个）进行放射学评估，并在术中进行可见性临床评估，量表为1至5（1-不可见，5-完全可见）。圆窗生态位（RWN）和圆窗膜（RWM）的可见性评估允许将差异（RWN减去RWM）用作圆窗上方悬垂尺寸的临床评估。
结果：对52例患者57耳的计算机断层扫描图像进行了圆窗入路分析。研究组包括26名女性和26名男性，年龄从1岁到80岁不等，平均年龄为41岁。在临床评估中，圆窗能见度为5，去除骨悬垂后，69%的患者。在39例(68%)病例中，通过圆窗进入耳蜗，13例（23％）通过圆窗延伸进入，5例（9％）进行了耳蜗造口术。使用文献（Chen_Angle）和我们的建议（RWM_prediction）中的一个参数，发现了与圆窗访问具有统计学意义的序数相关性。从描述圆窗骨悬垂的参数来看，使用文献中的参数（Sarafraz_OH和Mehanna_OH）发现了正相关（使用Kendall秩检验）。
结论：根据耳道后壁的解剖结构和面神经的位置，描述进入圆窗的放射学测量值最高。
结论：在未来，使用算法进行计算机断层扫描评估和机器人辅助手术将需要参数来评估圆窗通道，用于手术计划和电极的选择。总结了各种作者提出的参数，允许研究人员评估其在进一步临床实践中的有用性。
