Objective: To describe how the retrotympanic structures could influence the visibility of the round window niche (RWN) and of the round window membrane (RWM) during cochlear implant (CI) surgery. To investigate if a RW approach is possible even in those cases with unfavorable anatomy. Methods: Video recordings from 37 patients underwent CI were reviewed. The visibility of the RWN and RWM at different timepoints was assessed according to a modified version of the Saint Thomas Hospital classification. The structures responsible for hiding the RWN and RWM were evaluated. Results: After posterior tympanotomy 54% of cases had a limited exposure (class IIa, IIb, and III) of the RWN. After remodeling the retrotympanum, the RWN visibility achieved a significant increase, with 100% class I and IIa. Following the remodeling of RWN, a visibility >50% of the RWM surface was achieved in 100% of the cases. Conclusion: Remodeling the retrotympanum and the RWN significantly increase the exposure of the RWN and RWM respectively, allowing a RW insertion in all cases.
Surgical anatomy of posterior tympanotomy: influence of the retrotympanum on round window exposure / Maccarrone F.; Molinari G.; Fermi M.; Alicandri-Ciufelli M.; Presutti L.; Tassi S.; Villari D.; Negri M.. - In: JOURNAL OF LARYNGOLOGY AND OTOLOGY. - ISSN 0022-2151. - STAMPA. - 138:2(2023), pp. 1-6. [10.1017/S0022215123000944]
Surgical anatomy of posterior tympanotomy: influence of the retrotympanum on round window exposure
Molinari G.;Fermi M.;Presutti L.;
2023
Abstract
Objective: To describe how the retrotympanic structures could influence the visibility of the round window niche (RWN) and of the round window membrane (RWM) during cochlear implant (CI) surgery. To investigate if a RW approach is possible even in those cases with unfavorable anatomy. Methods: Video recordings from 37 patients underwent CI were reviewed. The visibility of the RWN and RWM at different timepoints was assessed according to a modified version of the Saint Thomas Hospital classification. The structures responsible for hiding the RWN and RWM were evaluated. Results: After posterior tympanotomy 54% of cases had a limited exposure (class IIa, IIb, and III) of the RWN. After remodeling the retrotympanum, the RWN visibility achieved a significant increase, with 100% class I and IIa. Following the remodeling of RWN, a visibility >50% of the RWM surface was achieved in 100% of the cases. Conclusion: Remodeling the retrotympanum and the RWN significantly increase the exposure of the RWN and RWM respectively, allowing a RW insertion in all cases.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.