New SMS Classification of Cochleovestibular Anomalies: Our Experience with 25 Cases of Type I Anomaly

Grover, Mohnish; Sharma, Shivam; Samdani, Sunil; Gupta, Gaurav; Preetam, Chappity; Gera, Kriti; Vaishnav, Jairaj Kumar; Hada, Mahendra Kumar

doi:10.1007/s12070-021-02442-x

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…Based on the above findings, the flowchart shown in Figure 6 describes a three-step sequential process for the accurate identifica- 15 In 2002, Sennaroglu et al 16 reported radiological findings differentiating IP-I which is characterized by a cystic cochlear portion from IP-II which has a further developed cochlear basal turn with a cystic apex. In 2021, Grover et al 17 The current study reported a sample size of 112, which is big compared to previous reports [14][15][16] and is considered sufficient to describe a classification of IEM types. The proposed step-by-step approach to evaluate pre-operative images enables a comprehensive approach in the identification of IEM types.…”

Section: Flowchart For Identifying Iem Typesmentioning

confidence: 66%

“… 15 In 2002, Sennaroglu et al 16 reported radiological findings differentiating IP‐I which is characterized by a cystic cochlear portion from IP‐II which has a further developed cochlear basal turn with a cystic apex. In 2021, Grover et al 17 reported a new classification of cochleovestibular malformation by specifically looking at the cochlear morphology, the modiolus, and the lamina cribrosa without considering IEM types that are associated with EVA. None of these reports on the classification of IEM types involved any systematic manner of visualizing the inner ear in both cochlear view and the mid‐modiolar section.…”

Section: Discussionmentioning

confidence: 99%

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A novel three‐step process for the identification of inner ear malformation types

Dhanasingh

Weiss

Erhard

et al. 2022

Laryngoscope Investig Oto

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Objective: We hypothesize that visualizing inner-ear systematically in both cochlear view (oblique coronal plane) and in mid-modiolar section (axial plane) and following three sequential steps simplifies, identification of inner-ear malformation types.Methods: Pre-operative computer-tomography (CT) scans of temporal bones of 112 ears with various inner ear malformation (IEM) types were taken for analysis.Images were analyzed using DICOM viewers, 3D slicer, and OTOPLAN ® . The innerear was captured in the oblique-coronal plane for the measurement of length and width of cochlear basal turn which is also called as A-, and B-values respectively (Step 1). In the same plane, the angular-turns of lateral-wall (LW) of cochlear basal turn were measured (Step 2). As Step 3, the mid-modiolar section of inner ear was captured in the axial plane by following the A-value and perpendicular to cochlear view. From the mid-modiolar section, the outer-contour of inner ear was captured manually by following contrasting gray area between fluid filled and bony promontory and was compared to known resembling objects to identify IEM types (Step 3). Results: Following reference values have emerged from our analysis: A-, and B-values (Step 1) on average are >8 mm and >5.5 mm respectively, in normal cochleae (NA), enlarged vestibular aqueduct syndrome (EVAS), incomplete partition (IP) type-I and -II, whereas it is <8 mm and <5.5 mm respectively, in IP type-III and cochlear hypoplasia (CH). Angular-turn of LW is consistently observed in cochlear basal turn (Step 2), is 540 in NA and EVAS, 450 in IP-II, and 360 in IP types I & III. In subjects with CH type, angular-turn of LW is either 360 or 450 or 540 . In true mid-modiolar section, outer-contour of inner-ear (Step-3), other than in CH and cystic inner-ear malformations, resembles recognizable shapes of known objects. Absence of EVA is an additional characteristic that confirms diagnosis of CH when the A-, B-values, and angular-turn of LW can be similar to other anatomical types. Drawing a straight line Anandhan E. Dhanasingh and Nora M. Weiss contributed equally to this study.

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Section: Flowchart For Identifying Iem Typesmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

A novel three‐step process for the identification of inner ear malformation types

Dhanasingh

Weiss

Erhard

et al. 2022

Laryngoscope Investig Oto

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“…The titles and abstracts of the remaining 1931 unique articles were screened, yielding 659 articles. Full‐text screening of these studies confirmed that 116 of these articles met the inclusion criteria 5,16‐130 . The selection process, including reasons for exclusion, is shown through a PRISMA flowchart in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…These patients would have also been implanted after the link with postoperative meningitis received significant attention in 2002, and after preventative recommendations such as pneumococcal vaccination were strongly put forth by organizations such as the CDC. 135 Of the 26 studies reporting the number of children under 5 years implanted, 12 studies reported that all implantations occurred from 2003 onward 20,39,43,49,59,66,100,[109][110][111]129,130 (Table 6 in Supplemental File S3, available online). We identified 1307 children in this age group implanted after this time (ie, without a positioner) and only 1 case of postoperative meningitis.…”

Section: Comparison To Other Studiesmentioning

confidence: 99%

The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta‐Analysis

Gowrishankar

Fleet

Tomasoni

et al. 2023

Otolaryngol.--head neck surg.

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Objective. This study aims to estimate the rate of postoperative meningitis (both immediate and long-term) in patients following cochlear implants (CIs). It aims to do so through a systematic review and meta-analysis of published studies tracking complications after CIs. Data Sources. MEDLINE, Embase, and Cochrane Library.Review Methods. This review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies tracking complications following CIs in patients were included. Exclusion criteria included non-English language studies and case series reporting <10 patients. Bias risk was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed through DerSimonian and Laird random-effects models.Results. A total of 116/1931 studies met the inclusion criteria and were included in the meta-analysis. Overall, there were 112 cases of meningitis in 58,940 patients after CIs. Metaanalysis estimated an overall rate of postoperative meningitis of 0.07% (95% confidence interval [CIs], 0.03%-0.1%; I 2 = 55%). Subgroup meta-analysis showed this rate had 95% CIs crossing 0% in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, those with postoperative acute otitis media (AOM), and those implanted less than 5 years. Conclusion.Meningitis is a rare complication following CIs. Our estimated rates of meningitis after CIs appear lower than prior estimates based on epidemiological studies in the early 2000s. However, the rate still appears higher than the baseline rate in the general population. The risk was very low in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, received unilateral or bilateral implantations, developed AOM, those implanted with a round window or cochleostomy techniques, and those under 5 years.

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“…The characteristics of all the included studies are outlined in Table 2 (5,12,14–16,22–54). All 38 studies were descriptive cohort studies without control (55).…”

Section: Resultsmentioning

confidence: 99%

Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis

et al. 2023

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Objective The objective of this study is to determine the rate of postoperative meningitis after cochlear implantation in those with inner ear malformations (IEMs) via meta-analysis. Data sources Medline, EMBASE, and the Cochrane Library. Methods This study was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Proportion meta-analysis was conducted through an inverse variance random-effect model based on arcsin transformation and presented as forest plots. Quality assessment of the included studies was performed through the National Institutes of Health Quality Assessment Tool. Results Overall, 38 of 2966 studies met the inclusion criteria and were included in the analysis. There were 10 cases of meningitis after cochlear implantation in 1300 malformed ears. The overall rate of meningitis after cochlear implantation in IEMs was 0.12% (95% confidence interval, 0.006–0.380%; I 2 = 0%). Cases occurred in incomplete partition (n = 5), Mondini deformity (n = 2), common cavity (n = 2), and enlarged internal auditory canal (n = 1). Six of 10 cases of postoperative meningitis occurred with an intraoperative cerebrospinal fluid leak. Conclusion In those with IEMs, the risk of meningitis after cochlear implantation is very low.

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New SMS Classification of Cochleovestibular Anomalies: Our Experience with 25 Cases of Type I Anomaly

Cited by 3 publications

References 23 publications

A novel three‐step process for the identification of inner ear malformation types

A novel three‐step process for the identification of inner ear malformation types

The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta‐Analysis

Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis

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