Faculty Opinions recommendation of Ultra-High-Resolution CT to Detect Intracochlear New Bone Formation after Cochlear Implantation.

The Cogan syndrome is a rare disorder characterized by nonsyphilitic interstitial keratitis and audiovestibular symptoms. Profound sensorineural hearing loss has been reported in approximately half of the patients with the Cogan syndrome resulting in candidacy for cochlear implantation in some patients. The current study is the first histopathologic report on the temporal bones of a patient with the Cogan syndrome who during life underwent bilateral cochlear implantation. Preoperative MRI revealed tissue with high density in the basal turns of both cochleae and both vestibular systems consistent with fibrous tissue due to labyrinthitis. Histopathology demonstrated fibrous tissue and new bone formation within the cochlea and vestibular apparatus, worse on the right. Severe degeneration of the vestibular end organs and new bone formation in the labyrinth were seen more on the right than on the left. Although severe bilateral degeneration of the spiral ganglion neurons was seen, especially on the right, the postoperative word discrimination score was between 50 and 60% bilaterally. Impedance measures were generally higher in the right ear, possibly related to more fibrous tissue and new bone found in the scala tympani on the right side.

Download Full-text

Predicting Round Window Visibility During Cochlear Implantation Using High Resolution CT Scan

The Journal of International Advanced Otology ◽

10.5152/iao.2018.4229 ◽

2018 ◽

pp. 15-15 ◽

Cited By ~ 1

Author(s):

Saad Elzayat ◽

◽

Mahmoud Mandour ◽

Rasha Lotfy ◽

Ali Mahrous ◽

...

Keyword(s):

High Resolution ◽

Ct Scan ◽

Cochlear Implantation ◽

Round Window ◽

High Resolution Ct

Download Full-text

The Crista Fenestra and Its Impact on the Surgical Approach to the Scala Tympani during Cochlear Implantation

Audiology and Neurotology ◽

10.1159/000471840 ◽

2017 ◽

Vol 22 (1) ◽

pp. 50-55 ◽

Cited By ~ 4

Author(s):

Roberto D. Angeli ◽

Joel Lavinsky ◽

Enio T. Setogutti ◽

Luiz Lavinsky

Keyword(s):

High Resolution ◽

Cochlear Implantation ◽

Round Window ◽

Ct Scanning ◽

Round Window Membrane ◽

Scala Tympani ◽

High Resolution Computed Tomography ◽

High Resolution Ct ◽

Round Window Niche ◽

Temporal Bones

Objective: The aim of this work was to describe the dimensions of the crista fenestra and determine its presence by means of high-resolution computed tomography (CT) for the purpose of cochlear implantation via the round window approach. Methods: A series of 10 adult human temporal bones underwent high-resolution CT scanning and were further dissected for microscopic study of the round window niche. Results: In all of the specimens, the round window membrane was fully visualized after the complete removal of bony overhangs. The crista fenestra was identified as a sharp bony crest located in the anterior and inferior borders of the niche; its area ranged from 0.28 to 0.80 mm2 (mean 0.51 ± 0.18). The proportion of the area occupied by the crista fenestra in the whole circumference of the round window ranged from 23 to 50% (mean 36%). We found a moderate positive correlation between the area of the niche and the dimensions of the crista fenestra (Spearman rho: 0.491). In every case, high-resolution CT scanning was unable to determine the presence of the crista fenestra. Conclusion: The crista fenestra occupies a variable but expressive area within the bony round window niche. Narrower round window niches tended to house smaller crests. The presence of the crista fenestra is an important obstacle to adequate access to the scala tympani. Nevertheless, a high-resolution CT scan provides no additional preoperative information with regard to its presence for the purpose of surgical access to the scala tympani via the round window niche.

Download Full-text

Role of high resolution CT and radiography in postoperative evaluation of cochlear implantation

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2011.04.001 ◽

2011 ◽

Vol 42 (2) ◽

pp. 177-184

Author(s):

Rehab Ahmed Hasan Zaghloul ◽

Mahmoud Lotfy El-Sheikh ◽

Fathy Ahmed Abd El-Baky ◽

Khaled Ibrahim El-Nouem

Keyword(s):

High Resolution ◽

Cochlear Implantation ◽

Postoperative Evaluation ◽

High Resolution Ct

Download Full-text

Diagnostic Protocol for Detecting Otosclerosis on High-Resolution Temporal Bone CT

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419859036 ◽

2019 ◽

Vol 128 (11) ◽

pp. 1054-1060 ◽

Cited By ~ 1

Author(s):

Lisa A. Brown ◽

Burce Ozgen Mocan ◽

Miriam I. Redleaf

Keyword(s):

High Resolution ◽

Bone Formation ◽

Temporal Bone ◽

Case Series ◽

Test Group ◽

Control Group ◽

New Bone Formation ◽

Retrospective Case ◽

High Resolution Computed Tomography ◽

Temporal Bones

Objectives: To present a systematic checklist to improve diagnosing otosclerosis (OS) on high-resolution computed tomography (HRCT) of the temporal bones and review this protocol’s efficacy in diagnosing OS on HRCT. Methods: A retrospective case series was performed at a University Referral Hospital in urban Chicago, Illinois. High-resolution computed tomographies of the temporal bone were reviewed including 17 ears in the test group with surgically confirmed OS and 21 ears in the control group surgically confirmed to not have OS. Preoperative HRCTs were evaluated by a single neuroradiologist using a systematic protocol created to assist in diagnosing OS. This looked for radiolucency at the fissula ante fenestram and pericochlear region, and new bone formation around the oval and round windows. Results: The radiologist accurately diagnosed OS in all 17 test group ears and ruled out OS in all 21 control group ears using the protocol. All 17 test ears were read to have lucency at the fissula ante fenestram, 9 (53.0%) to have new bone formation, and 8 (47.1%) to have cochlear lucency. The radiologist was more confident in diagnosing OS when cochlear lucency was present with the fissula ante fenestram lucency. Conclusions: This HRCT checklist is a highly accurate tool for evaluating the presence of OS when images are reviewed in the systematic fashion described. Imaging prior to surgery aids in counseling patients, preparing surgically, and excluding other pathologies.

Download Full-text

Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-206347 ◽

2015 ◽

Vol 75 (4) ◽

pp. 660-666 ◽

Cited By ~ 33

Author(s):

David Simon ◽

Francesca Faustini ◽

Arnd Kleyer ◽

Judith Haschka ◽

Matthias Englbrecht ◽

...

Keyword(s):

Psoriatic Arthritis ◽

High Resolution ◽

Bone Formation ◽

Ct Scans ◽

Healthy Controls ◽

New Bone Formation ◽

Quantitative Ct ◽

Koebner Phenomenon ◽

Metacarpal Head ◽

Bone Changes

ObjectivesTo search for structural bone changes in the joints of psoriasis patients without psoriatic arthritis (PsA).Methods55 psoriasis patients without any current or past symptoms of arthritis or enthesitis and 47 healthy controls were examined by high-resolution peripheral quantitative CT scans of the metacarpophalangeal joints. Number, size and exact localisation of erosions and enthesiophytes were recorded by analysing axial scans of the metacarpal heads and phalangeal bases and were confirmed in additional coronal and/or sagittal sections. In addition, we collected demographic and clinical data including subtype, duration and severity of psoriasis.ResultsPsoriasis patients showed a larger and significantly increased number of enthesiophytes (total number 306; mean±SD/patient 5.62±3.30) compared with healthy controls (total number 138; mean±SD/patient 3.04±1.81, p<0.001). Enthesiophytes were typically found at the dorsal and palmar sides of the metacarpal heads where functional entheses related to extensor and flexor tendons are localised. Bone erosions were rare and not significantly different between psoriasis patients and healthy controls. If present, erosions were almost exclusively found at the radial side of the second metacarpal head in both psoriasis patients and healthy controls.ConclusionsPsoriasis patients without PsA show substantial signs of enthesiophyte formation compared with healthy controls. These changes represent new bone formation at mechanically exposed sites of the joint and substantiate the concept of the existence of a ‘Deep Koebner Phenomenon’ at enthesial sites in psoriasis patients.

Download Full-text