Surgical anatomy of the round window with special reference to cochlear implantation

Franz, Burkhard; Clark, Graeme M.; Bloom, D. M.

doi:10.1017/s0022215100101343

Cited by 59 publications

(51 citation statements)

References 11 publications

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“…We will subsequently refer to this region as the anteroinferior margin of the RWM. There is a discrepancy over the nomenclature of the bony area adjacent to this region; some authors have referred to it as the crista fenestra (10,12,14,17) or crista semilunaris (13); others use the term postis anterior (18).…”

Section: Resultsmentioning

confidence: 99%

“…These areas were selected as previous studies have suggested placing the cochleostomy either directly through the RWM or in the otic capsule anterior, inferior, or anteroinferior to the RWM (7)(8)(9)(10)(11)(12)(13)(14). Using Amira's landmark editor, six points were placed on the model to represent potential sites of cochleostomy, three points evenly distributed across the surface of the RWM, and three points in the adjacent otic capsule (see Table 1).…”

Section: Evaluating the Anatomical Relationships Between Structures Imentioning

confidence: 99%

“…The anatomy of this region has previously been studied using either histological sections of temporal bones or dissected cadaveric specimens (10,(12)(13)(14)(15).…”

mentioning

confidence: 99%

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Anatomy of the Round Window and Hook Region of the Cochlea With Implications for Cochlear Implantation and Other Endocochlear Surgical Procedures

Wang

Northrop

et al. 2007

Otology &Amp; Neurotology

107

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Section: Resultsmentioning

confidence: 99%

Section: Evaluating the Anatomical Relationships Between Structures Imentioning

confidence: 99%

See 1 more Smart Citation

Anatomy of the Round Window and Hook Region of the Cochlea With Implications for Cochlear Implantation and Other Endocochlear Surgical Procedures

Wang

Northrop

et al. 2007

Otology &Amp; Neurotology

107

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show abstract

“…Since we skeletonized the FN and CT, we did not use the intraoperative bony landmarks mentioned previously in the medical literature. A previous study investigated the position of the RW niche through posterior tympanotomy (14). Our study focused on the exposure of the RW niche and its variations.…”

Section: Discussionmentioning

confidence: 99%

Revisiting the Anatomy of the Facial Recess: The Boundaries of the Round Window Exposure

et al. 2016

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Background:The exposure of the round window (RW) through the facial recess (FR) is sometimes partial. The anatomic variations that alter RW exposure during cochleostomy have not been clearly defined to date. Aims: The aim of this study was to assess the best FR position in which to achieve the widest exposure of the RW niche and to define the topographic relationship between two other important anatomical structures, the facial nerve (FN) and the chorda tympani (CT). Study Design: Cadaver study. Methods: Twenty-four temporal bones were included in the study. Anterior and posterior epitympanectomy and posterior tympanotomy were performed after mastoidectomy. Bone was removed until the FN and CT were skeletonized and the CT branching point was visible. Two pictures were taken. The first was taken when the facial recess was at its widest exposure, while the second was taken when the RW niche was maximally exposed through the facial recess. Various measurements were taken. Results: The RW niche was totally visible in 19 temporal bones (79.2%). The RW was partially visible in the remaining five bones (20.8%). The unexposed part of the RW lay posteromedial to the FN in these five bones. While the branching point of the CT could be visualized in all cases at the widest exposure of RW, the part of the FN distal to the branching point was hidden in eight subjects (33.3%) under the posterior wall of the external ear canal. Conclusions: The RW niche was totally visible in most of the temporal bones. The RW lay posteromedial to the FN in some cases and total exposure was impossible.

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“…Once these bony overhangs have been removed and the round window membrane is fully exposed, a sharp bony crest, the crista fenestra, is identified in the anteroinferior border of the niche [Franz et al, 1987;Atturo et al, 2014]. The membrane of the round window arises from the free edge of the crest.…”

mentioning

confidence: 99%

The Crista Fenestra and Its Impact on the Surgical Approach to the Scala Tympani during Cochlear Implantation

Angeli¹,

Lavinsky²,

Setogutti³

et al. 2017

Audiol Neurotol

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Objective: The aim of this work was to describe the dimensions of the crista fenestra and determine its presence by means of high-resolution computed tomography (CT) for the purpose of cochlear implantation via the round window approach. Methods: A series of 10 adult human temporal bones underwent high-resolution CT scanning and were further dissected for microscopic study of the round window niche. Results: In all of the specimens, the round window membrane was fully visualized after the complete removal of bony overhangs. The crista fenestra was identified as a sharp bony crest located in the anterior and inferior borders of the niche; its area ranged from 0.28 to 0.80 mm² (mean 0.51 ± 0.18). The proportion of the area occupied by the crista fenestra in the whole circumference of the round window ranged from 23 to 50% (mean 36%). We found a moderate positive correlation between the area of the niche and the dimensions of the crista fenestra (Spearman rho: 0.491). In every case, high-resolution CT scanning was unable to determine the presence of the crista fenestra. Conclusion: The crista fenestra occupies a variable but expressive area within the bony round window niche. Narrower round window niches tended to house smaller crests. The presence of the crista fenestra is an important obstacle to adequate access to the scala tympani. Nevertheless, a high-resolution CT scan provides no additional preoperative information with regard to its presence for the purpose of surgical access to the scala tympani via the round window niche.

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Surgical anatomy of the round window with special reference to cochlear implantation

Cited by 59 publications

References 11 publications

Anatomy of the Round Window and Hook Region of the Cochlea With Implications for Cochlear Implantation and Other Endocochlear Surgical Procedures

Anatomy of the Round Window and Hook Region of the Cochlea With Implications for Cochlear Implantation and Other Endocochlear Surgical Procedures

Revisiting the Anatomy of the Facial Recess: The Boundaries of the Round Window Exposure

The Crista Fenestra and Its Impact on the Surgical Approach to the Scala Tympani during Cochlear Implantation

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