Intraoperative high-resolution CT reveals electrode misplacement undetected by skull X-ray following cochlear implantation for IP-III inner ear malformation.

Incomplete partition type III (IP-III) malformation presents unique challenges for cochlear implantation. We report a critical intraoperative imaging comparison in a paediatric IP-III case where traditional skull X-ray failed to reveal the precise location of the cochlear electrode, while high-resolution CT (HRCT) precisely identified the site of electrode displacement. This finding demonstrates a significant limitation of routine radiography in these complex anatomies. Our experience underscores HRCT's critical role in accurately verifying electrode placement for patients with IP-III. Recognising this imaging discrepancy is essential for preventing undiagnosed malposition, guiding surgical revision and optimising auditory outcomes. Our findings support considering intraoperative HRCT as a valuable adjunct for confirming electrode position in IP-III implantation. Further multicentre studies are warranted to establish evidence-based imaging protocols for this challenging patient group.