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Research Paper | Otorhinolaryngology | India | Volume 12 Issue 4, April 2023
Imaging of Temporal Bone - A Road Map for Cochlear Implant Surgery
Dr. Sayali Jibhakate | Dr Kanchan Tadke
Abstract: Introduction: Based on high resolution computed tomography and magnetic resonance imaging findings, a 10 - point scoring and grading system was applied for preoperative assessment of patients planned for cochlear implantation. The study aimed to assess the various anatomical factors of temporal bone which would be helpful in contemplating specific complications faced during surgery. Methodology: This is a prospective study carried out at a tertiary referral center.40 patients with bilateral profound sensorineural hearing loss were evaluated by HRCT and MRI and subsequently underwent cochlear implant surgery. HRCT Temporal bone was performed on PHILLIPS Brilliant ICT 256 CT scanner while MRI was done on 1.5 Tesla MRI scanner. A 10 - point scoring chart was used based on specific imaging findings and all patients were assigned potential difficulty score (PDS). Surgical time was recorded in each case and each imaging finding on the scoring chart was correlated with the surgical timings. All patients underwent surgery via the standard posterior tympanotomy approach. Results: After applying the 10 - point scoring chart, the patients were categorized into three grades. Of the total patients studied 34% were categorized as Grade 1, 12.5 % as Grade 2 and 5% as Grade 3. Six out of the ten points in the scoring chart proved to be statistically significant in assessing the degree of surgical difficulty. Narrow facial recess was the best predictor of increased surgical timings. Conclusion: Radiological scoring and grading system based on HRCT and MRI temporal bone imagingcan prove a useful, systematic and helpfultool to surgeons for anticipating the level of surgical difficulty and plan accordingly. It was found that patients with PDS scores between 0 to 3 had uneventful and uncomplicated surgery with the lowest intraoperative times. Patients with PDS between 4 to 7 alert the surgeon to moderate surgical difficulty and longer intraoperative times. PDS of 8 and above indicate prolonged and difficult surgery.
Keywords: Cochlear Implant Surgery, High resolution computed tomography, Magnetic resonance imaging, Temporal bone
Edition: Volume 12 Issue 4, April 2023,
Pages: 1169 - 1174