Bilateral Dehiscence of the Bony Cochlear Basal Turn

Modugno, Giovanni Carlo; Brandolini, Cristina; Cappello, Ivanpietro; Pirodda, Antonio

doi:10.1001/archotol.130.12.1427

Cited by 33 publications

(23 citation statements)

References 6 publications

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“…CT scanning of the temporal bones showed unilateral dehiscence of the bony partition between the cochlear basal turn and the petrous carotid artery and contralateral thinning of this bony partition (CCP = 0.2 mm). The authors proposed that the similarity in audiometric findings in this patient, and that reported on by Modugno et al [9], may be attributable to pressure changes transmitted from the carotid to the cochlea, triggered by excitement, exercise, or atmospheric pressure change, resulting in hair cell stimulation. The mid-frequency SNHL would correspond to damage to the mid-portion of the cochlear basal turn.…”

Section: Discussionsupporting

confidence: 81%

“…Dehiscence of the bone between the petrous carotid artery and the cochlear basal turn has been reported in the literature [8,9], and this further entails specific surgical and clinical considerations. CI relies on electrode placement within the scala tympani, achieved via a cochleostomy typically made anterior and slightly inferior to the round window.…”

Section: Discussionmentioning

confidence: 99%

“…Modugno et al [9] described the case of a patient presenting with bilateral nonpulsatile tinnitus for many years. An audiometric assessment showed bilateral SNHL in the 4- to 8-kHz range.…”

Section: Discussionmentioning

confidence: 99%

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Contemporary Neuroradiographic Assessment of the Cochleo-Carotid Partition

Samy¹,

Pensak²

2016

ORL

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Purpose: The cochleo-carotid partition (CCP) describes the intimate anatomic relationship between the petrous carotid artery and the cochlear basal turn. This partition bears significant surgical and unique clinical relevance. The purpose of this paper is to radiographically assess the CCP and discuss its clinical implications. Methods: A total of 155 consecutive fine-cut temporal bone CT scans were retrospectively reviewed, and study scans were digitally analyzed in both axial and coronal views. The shortest distance between the petrous carotid canal and the cochlear basal turn was measured. Results: In all, 310 temporal bones were studied, with a mean CCP of 1.9 mm (range 0.2-8.5, SD 1.1). The following CCP measurements were obtained: ≤1.0 mm [n = 46 (14.8%)]; 1.1-2.0 mm [n = 161 (51.9%)]; 2.1-3.0 mm [n = 29 (9.4%)], and ≥4.0 mm [n = 12 (4.2%)]. One temporal bone (0.3%) had complete CCP dehiscence. There was a positive correlation between each patient's right and left CCP measures (p < 0.005) and a significant negative correlation between CCP grade and age (p = 0.027). Conclusions: The CCP is a narrow anatomic confinement measuring ≤2 mm in 66.7% of patients. Potential implications of the CCP include iatrogenic risks, its possible function as a third inner ear window in patients with audiovestibular symptoms, and pathophysiology of new-onset tinnitus following cochlear implantation.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Contemporary Neuroradiographic Assessment of the Cochleo-Carotid Partition

Samy¹,

Pensak²

2016

ORL

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“…From the literature, case reports on bony dehiscences between the cochlear basal turn and the carotid canal are known, and radiologic assessment of the so-called Bcochlear-carotid interval[ revealed corresponding measurements from 0 to 5 mm (29,30). The distance between cochlea and carotid canal varies, although the rapid narrowing of the scala tympani was a constant finding in our measurements.…”

Section: Dimensions Of the Cochlear Scalaementioning

confidence: 99%

The Internal Dimensions of the Cochlear Scalae With Special Reference to Cochlear Electrode Insertion Trauma

Biedron¹,

Prescher²,

Ilgner³

et al. 2010

Otology &Amp; Neurotology

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Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantation. Little attention was paid to the distinct narrowing of the scala tympani in the region of the ascending part of the cochlear duct, although from the literature, it is known that electrode insertion trauma frequently occurs here. Individual variations of the cochlear micromorphology may additionally contribute to the failure of preformed electrode arrays, but the challenge of guiding the electrode array around the first bend of the cochlear turn, that is, the pars ascendens, is obviously impaired by the interindividually constant narrowing in this area. Therefore, this finding may have implications on the development of electrode designs and insertion methods.

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“…Thin-section, high-resolution computed tomography (CT) without contrast enhancement was performed as a routine procedure to detect the anatomical conditions of the temporal bone and any associated changes that could be responsible for the patient's symptoms. 3 The axial and coronal scans revealed the presence of a lamellar calcification partly occluding the arterial lumen of the horizontal tract of the intrapetrous carotid artery, contiguous with the basal turn of the cochlea on the right side. This finding, which was interpreted as an atherosclerotic plaque (Figure 1), could explain the presence of the ipsilateral pulsatile tinnitus, which could have been caused by a turbulent blood flow at a stenotic arterial segment very near the cochlea.…”

Section: Report Of a Casementioning

confidence: 95%