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  • 1
    Online Resource
    Online Resource
    Cochlear and Vestibular Volumes in Inner Ear Malformations
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Otology & Neurotology Vol. 43, No. 8 ( 2022-9), p. e814-e819
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 8 ( 2022-9), p. e814-e819
    Abstract: A “gold standard” for quantitatively diagnosing inner ear malformations (IEMs) and a consensus on normative measurements are lacking. Reference ranges and cutoff values of inner ear dimensions may add in distinguishing IEM types. This study evaluates the volumes of the cochlea and vestibular system in different types of IEM. Study Design Retrospective cohort. Setting Tertiary academic center. Patients High-resolution CT scans of 115 temporal bones (70 with IEM; cochlear hypoplasia [CH]; n = 19), incomplete partition (IP) Types I and III (n = 16), IP Type II with an enlarged vestibular aqueduct (Mondini malformation; n = 16), enlarged vestibular aqueduct syndrome (n = 19), and 45 controls. Interventions Volumetry by software-based, semiautomatic segmentation, and 3D reconstruction. Main Outcome Measures Differences in volumes among IEM and between IEM types and controls; interrater reliability. Results Compared with controls (mean volume, 78.0 mm 3 ), only CH showed a significantly different cochlear volume (mean volume, 30.2 mm 3 ; p 〈 0.0001) among all types of IEM. A cutoff value of 60 mm 3 separated 100% of CH cases from controls. Compared with controls, significantly larger vestibular system volumes were found in Mondini malformation (mean difference, 22.9 mm 3 ; p = 0.009) and IP (mean difference, 24.1 mm 3 ; p = 0.005). In contrast, CH showed a significantly smaller vestibular system volume (mean difference, 41.1 mm 3 ; p 〈 0.0001). A good interrater reliability was found for all three-dimensional measurements (ICC = 0.86–0.91). Conclusion Quantitative reference values for IEM obtained in this study were in line with existing qualitative diagnostic characteristics. A cutoff value less than 60 mm 3 may indicate an abnormally small cochlea. Normal reference values for volumes of the cochlea and vestibular system may aid in diagnosing IEM.
    Type of Medium: Online Resource
    ISSN: 1537-4505 , 1531-7129
    URL: Article
    DOI: 10.1097/MAO.0000000000003615
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2058738-7
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  • 2
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    Online Resource
    Menière's Syndrome Associated With Fibrous Dysplasia of the Temporal Bone
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Otology & Neurotology Vol. 44, No. 6 ( 2023-7), p. e445-e448
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 6 ( 2023-7), p. e445-e448
    Type of Medium: Online Resource
    ISSN: 1537-4505 , 1531-7129
    URL: Article
    DOI: 10.1097/MAO.0000000000003891
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2058738-7
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  • 3
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    Internal auditory canal volume in normal and malformed inner ears
    Springer Science and Business Media LLC ; 2023
    In:  European Archives of Oto-Rhino-Laryngology Vol. 280, No. 5 ( 2023-05), p. 2149-2154
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 280, No. 5 ( 2023-05), p. 2149-2154
    Abstract: A narrow bony internal auditory canal (IAC) may be associated with a hypoplastic cochlear nerve and poorer hearing performances after cochlear implantation. However, definitions for a narrow IAC vary widely and commonly, qualitative grading or two-dimensional measures are used to characterize a narrow IAC. We aimed to refine the definition of a narrow IAC by determining IAC volume in both control patients and patients with inner ear malformations (IEMs). Methods In this multicentric study, we included high-resolution CT (HRCT) scans of 128 temporal bones (85 with IEMs: cochlear aplasia, n  = 11; common cavity, n  = 2; cochlear hypoplasia type, n  = 19; incomplete partition type I/III, n  = 8/8; Mondini malformation, n  = 16; enlarged vestibular aqueduct syndrome, n  = 19; 45 controls). The IAC diameter was measured in the axial plane and the IAC volume was measured by semi-automatic segmentation and three-dimensional reconstruction. Results In controls, the mean IAC diameter was 5.5 mm (SD 1.1 mm) and the mean IAC volume was 175.3 mm 3 (SD 52.6 mm 3 ). Statistically significant differences in IAC volumes were found in cochlear aplasia (68.3 mm 3 , p   〈  0.0001), IPI (107.4 mm 3 , p  = 0.04), and IPIII (277.5 mm 3 , p  = 0.0004 mm 3 ). Inter-rater reliability was higher in IAC volume than in IAC diameter (intraclass correlation coefficient 0.92 vs. 0.77). Conclusions Volumetric measurement of IAC in cases of IEMs reduces measurement variability and may add to classifying IEMs. Since a hypoplastic IAC can be associated with a hypoplastic cochlear nerve and sensorineural hearing loss, radiologic assessment of the IAC is crucial in patients with severe sensorineural hearing loss undergoing cochlear implantation.
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-022-07676-1
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459042-6
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  • 4
    Online Resource
    Online Resource
    Volumetry improves the assessment of the vestibular aqueduct size in inner ear malformation
    Springer Science and Business Media LLC ; 2023
    In:  European Archives of Oto-Rhino-Laryngology Vol. 280, No. 5 ( 2023-05), p. 2155-2163
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 280, No. 5 ( 2023-05), p. 2155-2163
    Abstract: Enlarged vestibular aqueduct (EVA) is a common finding associated with inner ear malformations (IEM). However, uniform radiologic definitions for EVA are missing and various 2D-measurement methods to define EVA have been reported. This study evaluates VA volume in different types of IEM and compares 3D-reconstructed VA volume to 2D-measurements. Methods A total of 98 high-resolution CT (HRCT) data sets from temporal bones were analyzed (56 with IEM; [cochlear hypoplasia (CH; n  = 18), incomplete partition type I (IPI; n  = 12) and type II (IPII; n  = 11) and EVA ( n  = 15)]; 42 controls). VA diameter was measured in axial images. VA volume was analyzed by software-based, semi-automatic segmentation and 3D-reconstruction. Differences in VA volume between the groups and associations between VA volume and VA diameter were assessed. Inter-rater-reliability (IRR) was assessed using the intra-class-correlation-coefficient (ICC). Results Larger VA volumes were found in IEM compared to controls. Significant differences in VA volume between patients with EVA and controls ( p   〈  0.001) as well as between IPII and controls ( p   〈  0.001) were found. VA diameter at the midpoint (VA midpoint) and at the operculum (VA operculum) correlated to VA volume in IPI (VA midpoint: r  = 0.78, VA operculum: r  = 0.91), in CH (VA midpoint: r  = 0.59, VA operculum: r  = 0.61), in EVA (VA midpoint: r  = 0.55, VA operculum: r  = 0.66) and in controls (VA midpoint: r  = 0.36, VA operculum: r  = 0.42). The highest IRR was found for VA volume (ICC = 0.90). Conclusions The VA diameter may be an insufficient estimate of VA volume, since (1) measurement of VA diameter does not reliably correlate with VA volume and (2) VA diameter shows a lower IRR than VA volume. 3D-reconstruction and VA volumetry may add information in diagnosing EVA in cases with or without additional IEM.
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-022-07681-4
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459042-6
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  • 5
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    Online Resource
    Comparing linear and non-linear models to estimate the appropriate cochlear implant electrode array length—are current methods precise enough?
    Springer Science and Business Media LLC ; 2023
    In:  European Archives of Oto-Rhino-Laryngology
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC
    Abstract: In cochlear implantation with flexible lateral wall electrode arrays, a cochlear coverage (CC) range between 70% and 80% is considered ideal for optimal speech perception. To achieve this CC, the cochlear implant (CI) electrode array has to be chosen according to the individual cochlear duct length (CDL). Here, we mathematically analyzed the suitability of different flexible lateral wall electrode array lengths covering between 70% and 80% of the CDL. Methods In a retrospective cross-sectional study preoperative high-resolution computed tomography (HRCT) from patients undergoing cochlear implantation was investigated. The CDL was estimated using an otosurgical planning software and the CI electrode array lengths covering 70–80% of the CDL was calculated using (i) linear and (ii) non-linear models. Results The analysis of 120 HRCT data sets showed significantly different model-dependent CDL. Significant differences between the CC of 70% assessed from linear and non-linear models (mean difference: 2.5 mm, p   〈  0.001) and the CC of 80% assessed from linear and non-linear models (mean difference: 1.5 mm, p   〈  0.001) were found. In up to 25% of the patients none of the existing flexible lateral wall electrode arrays fit into this range. In 59 cases (49,2%) the models did not agree on the suitable electrode arrays. Conclusions The CC varies depending on the underlying CDL approximation, which critically influences electrode array choice. Based on the literature, we hypothesize that the non-linear method systematically overestimates the CC and may lead to rather too short electrode array choices. Future studies need to assess the accuracy of the individual mathematical models.
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-023-08064-z
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459042-6
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  • 6
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    Online Resource
    Accuracy of Preoperative Cochlear Duct Length Estimation and Angular Insertion Depth Prediction
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Otology & Neurotology Vol. 44, No. 8 ( 2023-9), p. e566-e571
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 8 ( 2023-9), p. e566-e571
    Abstract: In cochlear implantation with flexible lateral wall electrodes, a cochlear coverage of 70% to 80% is assumed to yield an optimal speech perception. Therefore, fitting the cochlear implant (CI) to the patient’s individual anatomy has gained importance in recent years. For these reasons, the optimal angular insertion depth (AID) has to be calculated before cochlear implantation. One CI manufacturer offers a software that allows to visualize the AID of different electrode arrays. Here, it is hypothesized that these preoperative AID models overestimate the postoperatively measured insertion angle. This study aims to investigate the agreement between preoperatively estimated and postoperatively measured AID. Study Design Retrospective cross-sectional study. Setting Single-center tertiary referral center. Patients Patients undergoing cochlear implantation. Intervention Preoperative and postoperative high-resolution computed tomography (HRCT). Main Outcome Measures The cochlear duct length was estimated by determining cochlear parameters ( A value and B value), and the AID for the chosen electrode was (i) estimated by elliptic circular approximation by the software and (ii) measured manually postoperatively by detecting the electrode contacts after insertion. Results A total of 80 HRCT imaging data sets from 69 patients were analyzed. The mean preoperative AID estimation was 662.0° (standard deviation [SD], 61.5°), and the mean postoperatively measured AID was 583.9° (SD, 73.6°). In all cases (100%), preoperative AID estimation significantly overestimated the postoperative determined insertion angle (mean difference, 38.1°). A correcting factor of 5% on preoperative AID estimation dissolves these differences. Conclusions The use of an electrode visualization tool may lead to shorter electrode array choices because of an overestimation of the insertion angle. Applying a correction factor of 0.95 on preoperative AID estimation is recommended.
    Type of Medium: Online Resource
    ISSN: 1537-4505 , 1531-7129
    URL: Article
    DOI: 10.1097/MAO.0000000000003956
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2058738-7
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  • 7
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    Online Resource
    CT imaging-based approaches to cochlear duct length estimation—a human temporal bone study
    Springer Science and Business Media LLC ; 2022
    In:  European Radiology Vol. 32, No. 2 ( 2022-02), p. 1014-1023
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 32, No. 2 ( 2022-02), p. 1014-1023
    Abstract: Knowledge about cochlear duct length (CDL) may assist electrode choice in cochlear implantation (CI). However, no gold standard for clinical applicable estimation of CDL exists. The aim of this study is (1) to determine the most reliable radiological imaging method and imaging processing software for measuring CDL from clinical routine imaging and (2) to accurately predict the insertion depth of the CI electrode. Methods Twenty human temporal bones were examined using different sectional imaging techniques (high-resolution computed tomography [HRCT] and cone beam computed tomography [CBCT] ). CDL was measured using three methods: length estimation using (1) a dedicated preclinical 3D reconstruction software, (2) the established A-value method, and (3) a clinically approved otosurgical planning software. Temporal bones were implanted with a 31.5-mm CI electrode and measurements were compared to a reference based on the CI electrode insertion angle measured by radiographs in Stenvers projection (CDL reference ). Results A mean cochlear coverage of 74% (SD 7.4%) was found. The CDL reference showed significant differences to each other method ( p 〈 0.001). The strongest correlation to the CDL reference was found for the otosurgical planning software-based method obtained from HRCT (CDL SW-HRCT ;  r = 0.87, p 〈 0.001) and from CBCT (CDL SW-CBCT ;  r = 0.76, p 〈 0.001). Overall, CDL was underestimated by each applied method. The inter-rater reliability was fair for the CDL estimation based on 3D reconstruction from CBCT (CDL 3D-CBCT ; intra-class correlation coefficient [ICC] = 0.43), good for CDL estimation based on 3D reconstruction from HRCT (CDL 3D-HRCT ; ICC = 0.71), poor for CDL estimation based on the A-value method from HRCT (CDL A-HRCT ; ICC = 0.29), and excellent for CDL estimation based on the A-value method from CBCT (CDL A-CBCT ; ICC = 0.87) as well as for the CDL SW-HRCT  (ICC = 0.94), CDL SW-CBCT  (ICC = 0.94) and CDL reference  (ICC = 0.87). Conclusions All approaches would have led to an electrode choice of rather too short electrodes. Concerning treatment decisions based on CDL measurements, the otosurgical planning software-based method has to be recommended. The best inter-rater reliability was found for CDL A-CBCT , for CDL SW-HRCT , for CDL SW-CBCT , and for CDL reference . Key Points • Clinically applicable calculations using high-resolution CT and cone beam CT underestimate the cochlear size . • Ten percent of cochlear duct length need to be added to current calculations in order to predict the postoperative CI electrode position . • The clinically approved otosurgical planning software-based method software is the most suitable to estimate the cochlear duct length and shows an excellent inter-rater reliability .
    Type of Medium: Online Resource
    ISSN: 0938-7994 , 1432-1084
    URL: Article
    DOI: 10.1007/s00330-021-08189-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1472718-3
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