Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleHead and Neck Imaging

Prediction of Difficult Round Window Visibility during Cochlear Implantation via a Reformatted CT Facial Recess View: A Retrospective Study with Surgical Correlation

Si Wei Kheok, Jia Hui Ng, Lishya Liauw, Vanessa Yee Jueen Tan and Jiun Fong Thong
American Journal of Neuroradiology March 2025, 46 (3) 572-579; DOI: https://doi.org/10.3174/ajnr.A8503
Si Wei Kheok
aFrom the Department of Neuroradiology (S.W.K., L.L.), Singapore General Hospital, Singapore
bDuke-National University of Singapore Graduate Medical School (S.W.K., J.H.N., L.L.), Singapore
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Si Wei Kheok
Jia Hui Ng
bDuke-National University of Singapore Graduate Medical School (S.W.K., J.H.N., L.L.), Singapore
cDepartment of Otorhinolaryngology–Head and Neck Surgery (J.H.N., V.Y.J.T.), Singapore General Hospital, Singapore
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lishya Liauw
aFrom the Department of Neuroradiology (S.W.K., L.L.), Singapore General Hospital, Singapore
bDuke-National University of Singapore Graduate Medical School (S.W.K., J.H.N., L.L.), Singapore
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Lishya Liauw
Vanessa Yee Jueen Tan
cDepartment of Otorhinolaryngology–Head and Neck Surgery (J.H.N., V.Y.J.T.), Singapore General Hospital, Singapore
dDepartment of Otorhinolaryngology (J.F.T.), Tseung Kwan O Hospital, Hong Kong
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jiun Fong Thong
dDepartment of Otorhinolaryngology (J.F.T.), Tseung Kwan O Hospital, Hong Kong
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Graphical Abstract

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint

Abstract

BACKGROUND AND PURPOSE: Cochlear implant surgery is performed commonly through the facial recess via the round window (RW) approach. This study aims to evaluate the utility of reformatting the preoperative CT temporal bone scan into a CT facial recess view in alerting surgeons to a potentially difficult surgery with poorly visualized RW.

MATERIALS AND METHODS: This is a retrospective study of 41 patients (43 ears), who had undergone cochlear implant surgery. Intraoperative findings of RW position relative to second genu-mastoid portion of facial nerve, and RW membrane orientation were recorded by the surgeons. Preoperative CTs were analysed by 2 radiologists in both axial and reformatted planes, with the later simulating the surgeon’s view via the facial recess. Radiologic assessment markers include the facial nerve-chorda tympani nerve width measured 1.2 mm inferior to the exit point of the chorda tympani nerve into the tympanic cavity, RW position relative to second genu-mastoid segment of the facial nerve, and RW membrane’s angle from the vertical axis.

RESULTS: The best predictor for difficult RW intraoperative visibility is the RW position relative to the second genu-mastoid segment of the facial nerve lying lateral to it on CT facial recess reformatted images. A RW that lies partially to completely posterior to the posterior border of the second genu-mastoid segment of the facial nerve had up to 55.6% risk of encountering difficult access, while those positioned anterior to or partially anterior to the anterior edge of the second genu-mastoid segment of the facial nerve had 0% risk of difficult access (P < .05). There are substantial agreements in the intrarater (κ = 0.751, P < .001) and interrater reliability (κ = 0.698, P < .001). There is no significant association between surgical difficulty and facial nerve to chorda tympani distance or RW angle (P > .05).

CONCLUSIONS: Identification of RW positions in the reformatted CT facial recess view is a useful tool in predicting potentially difficult RW access in cochlear implant surgery.

ABBREVIATIONS:

FN-CTN
facial nerve to chorda tympani nerve width
ICC
intraclass correlation coefficient
IQR
interquartile range
RW
round window
  • © 2025 by American Journal of Neuroradiology
View Full Text

Log in using your username and password

Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 46 (3)
American Journal of Neuroradiology
Vol. 46, Issue 3
1 Mar 2025
  • Table of Contents
  • Index by author
  • Complete Issue (PDF)
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Prediction of Difficult Round Window Visibility during Cochlear Implantation via a Reformatted CT Facial Recess View: A Retrospective Study with Surgical Correlation
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
Si Wei Kheok, Jia Hui Ng, Lishya Liauw, Vanessa Yee Jueen Tan, Jiun Fong Thong
Prediction of Difficult Round Window Visibility during Cochlear Implantation via a Reformatted CT Facial Recess View: A Retrospective Study with Surgical Correlation
American Journal of Neuroradiology Mar 2025, 46 (3) 572-579; DOI: 10.3174/ajnr.A8503

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
CT facial recess and hard cochlear implantation
Si Wei Kheok, Jia Hui Ng, Lishya Liauw, Vanessa Yee Jueen Tan, Jiun Fong Thong
American Journal of Neuroradiology Mar 2025, 46 (3) 572-579; DOI: 10.3174/ajnr.A8503
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Graphical Abstract
    • Abstract
    • ABBREVIATIONS:
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSIONS
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Crossref (1)
  • Google Scholar

This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.

  • Correlation of mastoid air cells with area of the entrance to the facial recess and location of the vertical segment of the facial nerve
    Guanghui Wang, Deshang Chen, Yuxiang Wang, Liya Ding, Luan Xu, Beibei Xu, Shiwen Chen, Peidong Dai, Yuefeng Han
    Surgical and Radiologic Anatomy 2025 47 1

More in this TOC Section

  • FDG Uptake and Thyroid Cancer Post-BRAF Therapy
  • Normal Facial Nerve Enhancement on VIBE Sequence
  • Comprehensive Review of Inner Ear Anatomy on Photon-Counting CT
Show more Head and Neck Imaging

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire