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Dyna-CT of the temporal bone for case-specific three-dimensional rendering of the stapedial muscle for planning of electrically evoked stapedius reflex threshold determination during cochlear implantation directly from the stapedius muscle via a retrofacial approach: a pilot study
- Source :
- European Archives of Oto-Rhino-Laryngology. 277:975-985
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Evaluation of 3D Dyna-CTs to improve cochlear implantation (CI) planning and intraoperative electrically elicited stapedius reflex threshold (ESRT) measurements. A prospective observational cohort study was performed. Anonymized data collection of Dyna-CTs and CI surgeries in which a retrofacial approach was implemented to access the stapedius muscle. 3D Dyna-CTs of 30 patients and the intraoperative confirmation of the predication in 5/30 patients during CI surgery were evaluated. Inter-rater reliability was also analyzed along with the predictive value of this evaluation. 36 representative structures of the middle and inner ear and 3D renderings of the Dyna-CTs were evaluated by four otoneurological surgeons. Fleiss’ kappa values for the evaluation of the visibility were high (> 0.7) for most of the anatomical structures. The stapedius muscle was visible in 90% of the cases. Using the 3D data, the retrofacial access to the stapedius muscles was estimated as feasible in 86.7%. Fleiss’ kappa value of the evaluation of the accessibility was 0.942. The intraoperative exploration of the stapedius muscle confirmed the preoperative prediction in all five selected patients (four patients with predicted accessibility and one patient with predicted inaccessibility). The use of Dyna-CT and 3D rendering is a helpful tool for preoperative planning of cochlear implantations and ESRT measurements from the stapedius muscle via the retrofacial approach.
- Subjects :
- Adult
Male
Patient-Specific Modeling
medicine.medical_specialty
Anatomical structures
Ear, Middle
Pilot Projects
Stapedius muscle
03 medical and health sciences
Imaging, Three-Dimensional
0302 clinical medicine
Temporal bone
medicine
Humans
Prospective Studies
Ear Diseases
030223 otorhinolaryngology
Cochlear implantation
Acoustic reflex
Aged
Aged, 80 and over
Preoperative planning
business.industry
Reproducibility of Results
Temporal Bone
Auditory Threshold
Stapedius
General Medicine
Cone-Beam Computed Tomography
Middle Aged
Cochlear Implantation
Electric Stimulation
Reflex, Acoustic
Cochlear Implants
Surgery, Computer-Assisted
Otorhinolaryngology
Ear, Inner
030220 oncology & carcinogenesis
Female
Nuclear medicine
business
Kappa
Subjects
Details
- ISSN :
- 14344726 and 09374477
- Volume :
- 277
- Database :
- OpenAIRE
- Journal :
- European Archives of Oto-Rhino-Laryngology
- Accession number :
- edsair.doi.dedup.....68f0c35e5f548a1f776ff1bec0ca14db