Brief Title
Radiological Classification of the Facial Nerve
Official Title
Radiological Classification of the Vertical Segment of Facial Nerve in Cochlear Implant Surgery
Brief Summary
Cortical mastoidectomy and posterior tympanotomy is a classic approach for cochlear implant. Intimate knowledge of the relevant surgical anatomy of the temporal bone and facial recess is important to safely perform the posterior tympanotomy. Anatomical variation of facial nerve such as lateral or anterior position of vertical segment of facial nerve, will render this approach challenging. In this research, investigators proposed a Radiological Classification system of the position of vertical segment of facial nerve in relation to the lateral semicircular canal to predict difficult cases with narrow facial recess.
Detailed Description
Cochlear implantation done by mastoidectomy, posterior tympanotomy and round window membrane insertion or cochleostomy, if we have to. In cases with very laterally placed vertical segment of the facial nerve a trans- mastoid trans- attic approach used with trans canal monitoring as an alternative approach. Position of the vertical segment of the facial nerve (VFN) determined by coronal view HRCT of temporal bone, bone window of 0.6 mm thickness by using the cut posterior to the internal auditory canal at the level of lateral semicircular canal (LSCC) and then drawing a line parallel to the bony canal of the VFN and another parallel line on the outer bony wall of lateral semicircular canal (LSCC), and comparing level of both. The location of the facial nerve classified into normal if the FN is medial, same level or lateral to LSCC . Investigators referred the laterally placed FN (LPFN) when the whole vertical segment of facial nerve is lateral to LSCC. In addition, distance between VFN and LSCC was measured in cases of laterally placed FN. Investigators proposed a radiological classification system of the mastoid segment of facial nerve to predict round window niche accessibility through posterior tympanotomy pre-operatively by using coronal view computed tomography scan of temporal bone. Facial nerve position classified into 3 types in relation to LSCC: 1. TYPE I Medial to LSCC 2. TYPE II Same level of LSCC 3. TYPE III Laterally placed to LSCC III a) Less than 2mm III b) More than 2mm
Study Type
Observational
Primary Outcome
Radiological classification of vertical segment of facial nerve
Secondary Outcome
Surgical approach in cochlear implantation
Condition
Severe to Profound Sensorineural Hearing Loss
Intervention
cochlear implant surgery
Study Arms / Comparison Groups
Cochlear Implant
Description: Patients with severe to profound sensorineural hearing loss who underwent cochlear implant surgery
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Other
Estimated Enrollment
140
Start Date
January 2010
Completion Date
October 2016
Primary Completion Date
September 2016
Eligibility Criteria
Inclusion Criteria: - All patient who underwent cochlear implant surgery with preoperative computed tomography scan and high resolution CT scan of temporal bone Exclusion Criteria: - None
Gender
All
Ages
1 Year - 65 Years
Accepts Healthy Volunteers
No
Contacts
Laila M Al Telmesani, MD, ,
Location Countries
Saudi Arabia
Location Countries
Saudi Arabia
Administrative Informations
NCT ID
NCT02925208
Organization ID
ENT_1_10_2016
Responsible Party
Sponsor
Study Sponsor
Dammam University
Study Sponsor
Laila M Al Telmesani, MD, Principal Investigator, ENTDepartment, Dammam University, Dammam, Saudi Arabia
Verification Date
October 2016