Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hy...Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hypoplasia(CH)and common cavity(CC).Methods:Twelve children(eight males,four females),aged 10 to 43 months,with special IEMs were enrolled,and their inner ear structures were analyzed using detailed segmentation.Two surgical approaches were employed:the transmastoid slot labyrinthotomy approach(TSLA)for cases requiring customized electrodes,and the round window or cochleostomy approach for the remaining cases.Outcomes were evaluated using Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR),and Meaningful Auditory Integration Scale(MAIS/IT-MAIS)at 12 months post-implantation.Results:Two main types of malformed cochleae were identified:common cavity-like and primitive CH types.All patients exhibited cochlear nerve deficiency and significant bilateral differences in their inner ear structures.Four patients underwent TSLA with customized electrodes,while the remaining patients received lateral wall electrodes via the round window or cochleostomy approach.Most patients showed improvement in auditory and speech capabilities following implantation.Conclusion:Inner ear malformations with transitional forms between CH and CC present unique challenges,requiring detailed preoperative evaluation and customized surgical plans.Even in severe cases,carefully planned surgery can lead to meaningful auditory rehabilitation.展开更多
Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant ele...Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.展开更多
基金supported by the National Key Research and Development Program of China(grant no.2022YFC2402705)National Municipal Natural Science Foundation(grant no.82471161)Beijing Municipal Natural Science Foundation(grant no.7244308).
文摘Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hypoplasia(CH)and common cavity(CC).Methods:Twelve children(eight males,four females),aged 10 to 43 months,with special IEMs were enrolled,and their inner ear structures were analyzed using detailed segmentation.Two surgical approaches were employed:the transmastoid slot labyrinthotomy approach(TSLA)for cases requiring customized electrodes,and the round window or cochleostomy approach for the remaining cases.Outcomes were evaluated using Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR),and Meaningful Auditory Integration Scale(MAIS/IT-MAIS)at 12 months post-implantation.Results:Two main types of malformed cochleae were identified:common cavity-like and primitive CH types.All patients exhibited cochlear nerve deficiency and significant bilateral differences in their inner ear structures.Four patients underwent TSLA with customized electrodes,while the remaining patients received lateral wall electrodes via the round window or cochleostomy approach.Most patients showed improvement in auditory and speech capabilities following implantation.Conclusion:Inner ear malformations with transitional forms between CH and CC present unique challenges,requiring detailed preoperative evaluation and customized surgical plans.Even in severe cases,carefully planned surgery can lead to meaningful auditory rehabilitation.
基金supported by the National Key Research and Development Program of China(grant no.2022YFC2402705)National Municipal Natural Science Foundation(grant no.82471161)Beijing Municipal Natural Science Foundation(grant no.7244308)。
文摘Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.
