Microtomographic morphometry of the stapedius muscle and its tendon

Wojciechowski, Tomasz; Skadorwa, Tymon; Mévergnies, Jean-Gualbert Nève de; Niemczyk, Kazimierz

doi:10.1007/s12565-019-00490-6

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…The temporal bone is a complex structure housing small and functionally very important structures like the middle-ear including the ossicles; the inner-ear including the cochlea, vestibule and semicircular canals; the bony canals for the facial and vestibulocochlear nerves; and the related vasculature. The middle-ear houses the stapedius muscle (SM), the smallest muscle of the human body, the belly of which has a length of only 2–4 mm [ 1 ]. The SM contracts in response to loud sound stimuli, and this involuntary movement is known as stapedius reflex.…”

Section: Introductionmentioning

confidence: 99%

The use of a surgical planning tool for evaluating the optimal surgical accessibility to the stapedius muscle via a retrofacial approach during cochlear implant surgery: a feasibility study

et al. 2020

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Purpose During cochlear implant (CI) surgery, visual detection of the stapedius reflex as movements of the stapes tendon, electrically elicited via the CI, is a standard measure to confirm the system's functionality. Direction visualization of the stapedius muscle (SM) movements might be more reliable, but a safe access to the small SM is not defined. A new surgical planning tool for pre-operative evaluation of the accessibility to the stapedius muscle (SM) during a cochlear implantation (CI) via a retrofacial approach was now evaluated. Methods A surgical planning tool was developed in MATLAB using an image processing algorithm to evaluate drilling feasibility. A flat-panel computed tomography (CT) combining a rotational angiographic C-arm units with flat-panel detectors (Dyna-CT) was used. In total, 30 3D Dyna-CT-based temporal bone reconstructions were evaluated by automatized algorithms, generating a series of trajectories and comparing their feasibility and safety to reach the SM via a retrofacial approach. The predictability of the surgical planning tool results was tested in 5 patients. Results The surgical planning tool showed that a retrofacial access to the SM would be feasible in 25/30 cases. Moreover, the evaluation of the predictability of the results obtained with the surgical planning tool conducted during 5 CI surgeries confirmed the results. Both the surgical planning tool and the results on SM accessibility via retrofacial approach during CI showed that this is safe and feasible only when the SM-exposed area was > 25% of its total, the distance between the SM and the facial nerve was > 0.8 mm, and the surgical corridor diameter was > 3 mm. Conclusion The surgical planning tool seems to be useful for the pre-operative evaluation of the accessibility to the SM during a CI surgery via a retrofacial approach. Further prospective studies are needed to validate the results in larger cohorts.

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Section: Introductionmentioning

confidence: 99%

The use of a surgical planning tool for evaluating the optimal surgical accessibility to the stapedius muscle via a retrofacial approach during cochlear implant surgery: a feasibility study

et al. 2020

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“…When a surgeon wants to prevent an accidental damage, the main objective is to find posterior semicircular canal and to expose its blue line [ 12 ]. The belly of stapedius muscle is enclosed by bony tissue narrowing ST at the level of round window [ 16 , 35 ]. Our study suggest that STD and F-PSC enlarges inferiorly.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, images in the plane of the posterior semicircular canals were obtained and assessed. In this way, cross sections of all semicircular canals and other structures of the bony labyrinth, as well as typical images of the structures inside the tympanic cavity are obtained [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Sinus tympani revisited for planning retrofacial approach—radiologic study in pneumatized temporal bones and its surgical implications

Wojciechowski

Bartoszewicz

Szopiński

2022

Eur Arch Otorhinolaryngol

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Background and purpose Retrofacial approach (RFA) is an access route to sinus tympani (ST) and it is used in cholesteatoma surgery, especially when type C ST is encountered. It may also be used to gain an access to stapedius muscle to assess the evoked stapedius reflex threshold. The primary object of this study was to evaluate the morphology of sinus tympani and its relationship to facial nerve (FN) and posterior semicircular canal (PSC) in context of planning retrofacial approach in pneumatized temporal bones. Methods CBCT of 130 adults were reviewed. The type of sinus tympani was assessed according to Marchioni's classification. Width of entrance to sinus tympani (STW), depth of ST (STD), distance between the posterior semicircular canal and facial nerve (F-PSC), distance between the latter plane to the floor of ST at the right angle (P-ST) were measured at level of round window (RW) and pyramidal ridge (PR). Results All of the bones were well-aerated and classified in Dexian Tan pneumatization group 3 or 4. Type B of ST is dominant (70.8%) in adult population with no history of inflammatory otologic diseases, followed by type C (22.7%) and then type A (6.5%). The depth of ST (STD) presented significant deviations (ANOVA, p < 0.05) among all three types. STW reaches greater values on the level of PR. F-PSC does not correlate with type of ST. In over 75% of examined type C sinus tympani the distance P-ST was less than 1 mm. Conclusions The qualitative classification of the sinus tympani into types A, B and C, introduced by Marchioni is justified by statistically significant differences of depth between individual types of tympanic sinuses. The STW distance reaches greater values inferiorly—it may suggest that RFA should be performed in infero-superior manner rather than opposite direction. Preoperative assessment of temporal bones CT scans gives very important information about size of sinus tympani and distance between FN and PSC.

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“…Poschl projection is parallel to the superior semicircular canal—it allows the identification of the cochlear promontory, round window and its posterior pillar. This projection is widely used in temporal bone studies [ 5 , 30 ].…”

Section: Methodsmentioning

confidence: 99%

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

et al. 2021

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Purpose Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. In such a surgical strategy the electrode is placed in the round window’s region throughout posterior tympanotomy. Common accessible needle-shaped electrodes using is difficult in achieving intraoperative stabilization. The aim of the study is to assess the dimensions and shape of sinus tympani, basing on the micro computed tomography scans for purposes of establishing the possible new electrocochleography electrode shape. Materials and methods Sixteen fresh frozen cadaveric temporal bones were dissected. MicroCT measurements included the depth and the width of sinus tympani, width of facial canal with stapedius muscle chamber. Obtained data were analyzed statistically with the use of RStudio 1.3.959 software. Results The highest average width of sinus tympani amounted for 2.68 mm, depth measured at the round window plane for 3.19 mm. Width of facial canal with stapedius muscle chamber highest average values at the round window plane- 3.32 mm. The lowest average minimum and maximum values were calculated at the 1 mm above the round window plane. The highest average posterior tympanotomy width was 2.91 mm. Conclusions The shape of the tympanic sinus is like a trough with the narrowest and deepest dimensions in the middle part. The ST shape and dimensions should be taken into account in constructing the ECochG electrode, designed for optimal placement through posterior tympanotomy approach.

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Microtomographic morphometry of the stapedius muscle and its tendon

Cited by 13 publications

References 18 publications

The use of a surgical planning tool for evaluating the optimal surgical accessibility to the stapedius muscle via a retrofacial approach during cochlear implant surgery: a feasibility study

The use of a surgical planning tool for evaluating the optimal surgical accessibility to the stapedius muscle via a retrofacial approach during cochlear implant surgery: a feasibility study

Sinus tympani revisited for planning retrofacial approach—radiologic study in pneumatized temporal bones and its surgical implications

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

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