On the Anatomy of the 'Hook' Region of the Human Cochlea and How It Relates to Cochlear Implantation

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Atturo, FrancescaUppsala universitet,Öron-, näs- och halssjukdomar (author)

On the Anatomy of the 'Hook' Region of the Human Cochlea and How It Relates to Cochlear Implantation

Article/chapterEnglish2014

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2014-11-04
S. Karger AG,2014
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LIBRIS-ID:oai:DiVA.org:uu-244609
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-244609URI
https://doi.org/10.1159/000365585DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: The optimal insertion route for an electrode array in hearing preservation cochlear implantation (CI) surgery is still tentative. Both cochleostomy (CO) and round window (RW) techniques are used today. In the present study we analyzed size variations and topographic anatomy of the 'hook' region of the human cochlea to better comprehend the Testo effects of various electric array insertion modes. Material and Methods: Size variations of the cochlear 'hook' region were assessed in 23 human, microdissected temporal bones by measuring the distances between the oval and round windows, also outlining the spiral ligament/spiral lamina. Influence of size variations on spiral ligament position and fundamentals for different surgical approaches were evaluated in a subset of 'small' and 'large' cochleae performing different types of CO. In addition, the relationship between the microdissected accessory canal housing the inferior cochlear vein and the RW was analyzed. Results: The lateral vestibular wall and the cochlear 'hook' displayed large anatomic variations that greatly influenced the size of the potential surgical area. Results showed that only very inferiorly located CO entered the scala tympani without causing trauma to the spiral ligament and spiral lamina. An inferior approach may challenge the inferior cochlear vein. Conclusion: Preoperative assessment of the distance between the round and oval windows may direct the surgeon before CI hearing- preservation surgery. CO techniques, especially in 'small' ears, may lead to frequent damage to the inner ear structures. In those cases with substantial residual hearing, CI surgery may be better performed through a RW approach.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Cochlear implant
Cochleostomy
Cochlear anatomy
Hearing preservation surgery

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Barbara, Maurizio (author)
Rask-Andersen, HelgeUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)helgraan (author)
Uppsala universitetÖron-, näs- och halssjukdomar (creator_code:org_t)

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In:Audiology & neuro-otology: S. Karger AG19:6, s. 378-3851420-30301421-9700

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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By the university: Uppsala University

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