The Usefulness of Reconstructed 3D Images in Surgical Planning for Cochlear Implantation in a Malformed Ear with an Abnormal Course of the Facial Nerve
Identifieur interne : 002129 ( Main/Curation ); précédent : 002128; suivant : 002130The Usefulness of Reconstructed 3D Images in Surgical Planning for Cochlear Implantation in a Malformed Ear with an Abnormal Course of the Facial Nerve
Auteurs : Minoru Hara [Japon] ; Haruo Takahashi [Japon] ; Yukihiko Kanda [Japon]Source :
- Clinical and Experimental Otorhinolaryngology [ 1976-8710 ] ; 2012.
Abstract
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.
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.
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.
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.
Url:
DOI: 10.3342/ceo.2012.5.S1.S48
PubMed: 22701148
PubMed Central: 3369982
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PMC:3369982Le document en format XML
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<author><name sortKey="Hara, Minoru" sort="Hara, Minoru" uniqKey="Hara M" first="Minoru" last="Hara">Minoru Hara</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Otorhinolaryngology Head and Neck Surgery, Nagasaki University Hospital, Nagasaki, Japan.</nlm:aff>
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<author><name sortKey="Takahashi, Haruo" sort="Takahashi, Haruo" uniqKey="Takahashi H" first="Haruo" last="Takahashi">Haruo Takahashi</name>
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<author><name sortKey="Kanda, Yukihiko" sort="Kanda, Yukihiko" uniqKey="Kanda Y" first="Yukihiko" last="Kanda">Yukihiko Kanda</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Usefulness of Reconstructed 3D Images in Surgical Planning for Cochlear Implantation in a Malformed Ear with an Abnormal Course of the Facial Nerve</title>
<author><name sortKey="Hara, Minoru" sort="Hara, Minoru" uniqKey="Hara M" first="Minoru" last="Hara">Minoru Hara</name>
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<author><name sortKey="Takahashi, Haruo" sort="Takahashi, Haruo" uniqKey="Takahashi H" first="Haruo" last="Takahashi">Haruo Takahashi</name>
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<author><name sortKey="Kanda, Yukihiko" sort="Kanda, Yukihiko" uniqKey="Kanda Y" first="Yukihiko" last="Kanda">Yukihiko Kanda</name>
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<series><title level="j">Clinical and Experimental Otorhinolaryngology</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusion</title>
<p>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.</p>
</sec>
</div>
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