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The Usefulness of Reconstructed 3D Images in Surgical Planning for Cochlear Implantation in a Malformed Ear with an Abnormal Course of the Facial Nerve.

Hara M, Takahashi H, Kanda Y - Clin Exp Otorhinolaryngol (2012)

Bottom Line: CI was performed with no problems, in the same manner as in Case 1.We were able to successfully depict the structures of the inner ear, ossicles, and FN as 3D images, which are very easy to understand visually and intuitively.These 3D images of the malformed ear are useful in preoperative image simulation and in surgical planning for those performing a CI procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Nagasaki University Hospital, Nagasaki, Japan.

ABSTRACT

Objectives: It is not unusual for a cochlear implantation (CI) candidate to have some type of ear malformation, in particular an abnormal course of the facial nerve (FN). In this study, we attempted to reconstruct a three-dimensional (3D) image of temporal bone structures with malformation using computed tomography (CT) imaging and examined its usefulness in the surgical planning of CI in a malformed ear.

Methods: We prepared 3D images for 6 separate CI cases before surgery. First, we manually colored preoperative CT images using Photoshop CS Extended. We then converted the colored CT images to 3D images using Delta Viewer, free-ware for Macintosh. Before surgery, we discussed any problems anticipated based on the 3D images and plans for surgery with those who would be performing the CI.

Results: Case 1: The subject was a 3-year-old boy with malformed ossicles, semicircular canal (SC) hypoplasia, internal auditory canal stenosis, and an abnormal course of the FN. 3D image indicated that the stapes were absent, and the FN was more anteriorly displaced, so that it was difficult to perform cochleostomy. The surgical findings were similar to those depicted on the 3D image, so we could insert an electrode based on the preoperative image simulation without complications. Case 2: The subject was a 7-year-old boy with malformed stapes, atresia of the round window, cochlear and SC aplasia, and an abnormal course of the FN with bifurcation. CI was performed with no problems, in the same manner as in Case 1.

Conclusion: We were able to successfully depict the structures of the inner ear, ossicles, and FN as 3D images, which are very easy to understand visually and intuitively. These 3D images of the malformed ear are useful in preoperative image simulation and in surgical planning for those performing a CI procedure.

No MeSH data available.


Related in: MedlinePlus

Example of Delta Viewer 3 dimensional image of normal temporal bone structures of left ear based on computed tomography image. Image (A) is antero-lateral inferior view, and image (B) is superior view. The bony labyrinth was shaded in blue and includes the cochlea (Co), vestibule (V), anterior semicircular canal (ASC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), and round window (RW). The internal auditory canal (IAC) and facial nerve (FN) are shaded in yellow. The ossicles are shaded in red and include the malleus (M), incus (I), and stapes (S). The annulus tympanicus (AT) and vestibular aqueduct (VA) are shaded in green and purple, respectively.
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Figure 1: Example of Delta Viewer 3 dimensional image of normal temporal bone structures of left ear based on computed tomography image. Image (A) is antero-lateral inferior view, and image (B) is superior view. The bony labyrinth was shaded in blue and includes the cochlea (Co), vestibule (V), anterior semicircular canal (ASC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), and round window (RW). The internal auditory canal (IAC) and facial nerve (FN) are shaded in yellow. The ossicles are shaded in red and include the malleus (M), incus (I), and stapes (S). The annulus tympanicus (AT) and vestibular aqueduct (VA) are shaded in green and purple, respectively.

Mentions: Fig. 1 is a DV-3D image of the normal temporal bone structures. We can rotate DV-3D images freely using the DV application.


The Usefulness of Reconstructed 3D Images in Surgical Planning for Cochlear Implantation in a Malformed Ear with an Abnormal Course of the Facial Nerve.

Hara M, Takahashi H, Kanda Y - Clin Exp Otorhinolaryngol (2012)

Example of Delta Viewer 3 dimensional image of normal temporal bone structures of left ear based on computed tomography image. Image (A) is antero-lateral inferior view, and image (B) is superior view. The bony labyrinth was shaded in blue and includes the cochlea (Co), vestibule (V), anterior semicircular canal (ASC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), and round window (RW). The internal auditory canal (IAC) and facial nerve (FN) are shaded in yellow. The ossicles are shaded in red and include the malleus (M), incus (I), and stapes (S). The annulus tympanicus (AT) and vestibular aqueduct (VA) are shaded in green and purple, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369982&req=5

Figure 1: Example of Delta Viewer 3 dimensional image of normal temporal bone structures of left ear based on computed tomography image. Image (A) is antero-lateral inferior view, and image (B) is superior view. The bony labyrinth was shaded in blue and includes the cochlea (Co), vestibule (V), anterior semicircular canal (ASC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), and round window (RW). The internal auditory canal (IAC) and facial nerve (FN) are shaded in yellow. The ossicles are shaded in red and include the malleus (M), incus (I), and stapes (S). The annulus tympanicus (AT) and vestibular aqueduct (VA) are shaded in green and purple, respectively.
Mentions: Fig. 1 is a DV-3D image of the normal temporal bone structures. We can rotate DV-3D images freely using the DV application.

Bottom Line: CI was performed with no problems, in the same manner as in Case 1.We were able to successfully depict the structures of the inner ear, ossicles, and FN as 3D images, which are very easy to understand visually and intuitively.These 3D images of the malformed ear are useful in preoperative image simulation and in surgical planning for those performing a CI procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Nagasaki University Hospital, Nagasaki, Japan.

ABSTRACT

Objectives: It is not unusual for a cochlear implantation (CI) candidate to have some type of ear malformation, in particular an abnormal course of the facial nerve (FN). In this study, we attempted to reconstruct a three-dimensional (3D) image of temporal bone structures with malformation using computed tomography (CT) imaging and examined its usefulness in the surgical planning of CI in a malformed ear.

Methods: We prepared 3D images for 6 separate CI cases before surgery. First, we manually colored preoperative CT images using Photoshop CS Extended. We then converted the colored CT images to 3D images using Delta Viewer, free-ware for Macintosh. Before surgery, we discussed any problems anticipated based on the 3D images and plans for surgery with those who would be performing the CI.

Results: Case 1: The subject was a 3-year-old boy with malformed ossicles, semicircular canal (SC) hypoplasia, internal auditory canal stenosis, and an abnormal course of the FN. 3D image indicated that the stapes were absent, and the FN was more anteriorly displaced, so that it was difficult to perform cochleostomy. The surgical findings were similar to those depicted on the 3D image, so we could insert an electrode based on the preoperative image simulation without complications. Case 2: The subject was a 7-year-old boy with malformed stapes, atresia of the round window, cochlear and SC aplasia, and an abnormal course of the FN with bifurcation. CI was performed with no problems, in the same manner as in Case 1.

Conclusion: We were able to successfully depict the structures of the inner ear, ossicles, and FN as 3D images, which are very easy to understand visually and intuitively. These 3D images of the malformed ear are useful in preoperative image simulation and in surgical planning for those performing a CI procedure.

No MeSH data available.


Related in: MedlinePlus