Scholarlink

Purpose <p>Although computed tomography (CT) can predict round window (RW) visibility at posterior tympanotomy pre-operatively, there is a trend towards the application of using magnetic resonance imaging (MRI) alone for cochlear implant (CI) planning. This study assessed the potential of a novel “Black Bone” (BB) MRI sequence to determine RW visibility during posterior tympanotomy.</p> Methods <p>Patients underwent BB MRI as part of pre-operative CI planning. Two independent radiologists performed 5 landmark-based MRI measurements. RW visibility was recorded during posterior tympanotomy as &gt; 50% or &lt; 50% visibility. Patients with undefinable landmarks or absent surgical grading were excluded. Mann-Whitney U or t-tests compared MRI measurements to RW visibility whilst step wise logistic regression determined significant predictors.</p> Results <p>86 patients (40 male; median 10.5 years) and 129 implanted ears (43 unilateral, 43 bilateral; 52 adult, 77 paediatric) were evaluated. There were 109/129 ears with &gt; 50% and 20/129 ears with &lt; 50% RW visibility. The external auditory canal (EAC) angle was increased in paediatric patients with &gt; 50% RW visibility (<i>P</i> = 0.033; AUROC 0.689; 73.4% sensitive, 69.2% specific with threshold 6.2<sup>o</sup>) with ICC = 0.598. The facial recess distance, facial nerve location, and modified RW niche angle were increased in adult patients with &gt; 50% RW visibility but only modified RW niche angle was significant on stepwise regression (<i>P</i> = 0.016; AUROC 0.805; 82.2% sensitive, 71.4% specific with threshold 17.95<sup>o</sup>) with ICC = 0.578.</p> Conclusion <p>The visibility of RW at posterior tympanotomy may be determined with pre-operative BB MRI. The optimal predictive measurements differ between adult and paediatric patients and there is superior performance in adults.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The prediction of round window visibility at posterior-tympanotomy for cochlear implantation with “black bone” magnetic resonance imaging

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月1日

查看全文
  • Hoi Ming Kwok,
  • Cameron Spence,
  • Emily Hocknell,
  • Irumee Pai,
  • Steve Connor

摘要

Purpose

Although computed tomography (CT) can predict round window (RW) visibility at posterior tympanotomy pre-operatively, there is a trend towards the application of using magnetic resonance imaging (MRI) alone for cochlear implant (CI) planning. This study assessed the potential of a novel “Black Bone” (BB) MRI sequence to determine RW visibility during posterior tympanotomy.

Methods

Patients underwent BB MRI as part of pre-operative CI planning. Two independent radiologists performed 5 landmark-based MRI measurements. RW visibility was recorded during posterior tympanotomy as > 50% or < 50% visibility. Patients with undefinable landmarks or absent surgical grading were excluded. Mann-Whitney U or t-tests compared MRI measurements to RW visibility whilst step wise logistic regression determined significant predictors.

Results

86 patients (40 male; median 10.5 years) and 129 implanted ears (43 unilateral, 43 bilateral; 52 adult, 77 paediatric) were evaluated. There were 109/129 ears with > 50% and 20/129 ears with < 50% RW visibility. The external auditory canal (EAC) angle was increased in paediatric patients with > 50% RW visibility (P = 0.033; AUROC 0.689; 73.4% sensitive, 69.2% specific with threshold 6.2o) with ICC = 0.598. The facial recess distance, facial nerve location, and modified RW niche angle were increased in adult patients with > 50% RW visibility but only modified RW niche angle was significant on stepwise regression (P = 0.016; AUROC 0.805; 82.2% sensitive, 71.4% specific with threshold 17.95o) with ICC = 0.578.

Conclusion

The visibility of RW at posterior tympanotomy may be determined with pre-operative BB MRI. The optimal predictive measurements differ between adult and paediatric patients and there is superior performance in adults.