Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2024
Radioclinical Assessment of Posterior Tympanotomy Difficulties during Ordinary Cochlear Implantation: A Prospective Case-Series Study.
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Barbara Maurizio, Margani Valerio, Covelli Edoardo, Romano Andrea, Bozzao Alessandro, Lotfy Rasha, Mandour Mahmoud, Swaid Ali, Soltan Islam, Elzayat Saad, Elfarargy Haitham H
Аннотация
OBJECTIVES: This study proposes a preoperative radiologic scoring system for predicting posterior tympanotomy (PT) and mastoidectomy-associated difficulties during cochlear implantation (CI).
STUDY DESIGN: It was a prospective case-series study.
SETTINGS: The included CI surgeries were performed at tertiary referral institutions from October 2022 to April 2023.
SUBJECTS: We included 73 CI candidates performed via the PT approach.
INTERVENTION: The proposed radiologic score, composed of 13 items, was fulfilled and evaluated before each CI surgery.
MAIN OUTCOME MEASURE: We correlated this score with the intraoperative difficulty and surgical duration.
RESULTS: The operation was straightforward in 42 patients with a score of 3.87 ± 1.72 and challenging in 31 patients with a score of 10.66 ± 1.73. The radiologic score was strongly correlated with the surgical difficulty and duration (p < 0.0001).
CONCLUSIONS: Our proposed radiologic score was a valid, reliable, and precise tool to predict intraoperative difficulty during cochlear implantation. Chorda-facial angle was the strongest predictor, significantly affecting the difficulty, surgical duration, and preoperative radiologic score. A score equal to or more than 7.5 was expected to be associated with surgical difficulty.
STUDY DESIGN: It was a prospective case-series study.
SETTINGS: The included CI surgeries were performed at tertiary referral institutions from October 2022 to April 2023.
SUBJECTS: We included 73 CI candidates performed via the PT approach.
INTERVENTION: The proposed radiologic score, composed of 13 items, was fulfilled and evaluated before each CI surgery.
MAIN OUTCOME MEASURE: We correlated this score with the intraoperative difficulty and surgical duration.
RESULTS: The operation was straightforward in 42 patients with a score of 3.87 ± 1.72 and challenging in 31 patients with a score of 10.66 ± 1.73. The radiologic score was strongly correlated with the surgical difficulty and duration (p < 0.0001).
CONCLUSIONS: Our proposed radiologic score was a valid, reliable, and precise tool to predict intraoperative difficulty during cochlear implantation. Chorda-facial angle was the strongest predictor, significantly affecting the difficulty, surgical duration, and preoperative radiologic score. A score equal to or more than 7.5 was expected to be associated with surgical difficulty.