Radiological Classification of the Facial Nerve

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 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

NCT ID

NCT02925208

Organization ID

ENT_1_10_2016

Responsible Party

Sponsor

Study Sponsor

Imam Abdulrahman Bin Faisal University

Study Sponsor

Laila M Al Telmesani, MD, Principal Investigator, ENTDepartment, Dammam University, Dammam, Saudi Arabia

Verification Date

October 2016