Radiological Classification of the Facial Nerve

Completed

• Conditions: Severe to Profound Sensorineural Hearing Loss; Undergoing Cochlear Implant Surgery
• Interventions: Other: cochlear implant surgery

• Registration Number: NCT02925208
• Lead Sponsor: Imam Abdulrahman Bin Faisal University

Brief Summary

Cortical mastoidectomy and posterior tympanotomy is a classic approach for cochlear implant. Intimate knowledge of the relevant surgical anatomy of the temporal bone and facial recess is important to safely perform the posterior tympanotomy. Anatomical variation of facial nerve such as lateral or anterior position of vertical segment of facial nerve, will render this approach challenging. In this research, investigators proposed a Radiological Classification system of the position of vertical segment of facial nerve in relation to the lateral semicircular canal to predict difficult cases with narrow facial recess.

Detailed Description

Cochlear implantation done by mastoidectomy, posterior tympanotomy and round window membrane insertion or cochleostomy, if we have to. In cases with very laterally placed vertical segment of the facial nerve a trans- mastoid trans- attic approach used with trans canal monitoring as an alternative approach. Position of the vertical segment of the facial nerve (VFN) determined by coronal view HRCT of temporal bone, bone window of 0.6 mm thickness by using the cut posterior to the internal auditory canal at the level of lateral semicircular canal (LSCC) and then drawing a line parallel to the bony canal of the VFN and another parallel line on the outer bony wall of lateral semicircular canal (LSCC), and comparing level of both. The location of the facial nerve classified into normal if the FN is medial, same level or lateral to LSCC . Investigators referred the laterally placed FN (LPFN) when the whole vertical segment of facial nerve is lateral to LSCC. In addition, distance between VFN and LSCC was measured in cases of laterally placed FN.

Investigators proposed a radiological classification system of the mastoid segment of facial nerve to predict round window niche accessibility through posterior tympanotomy pre-operatively by using coronal view computed tomography scan of temporal bone. Facial nerve position classified into 3 types in relation to LSCC:

1. TYPE I Medial to LSCC

2. TYPE II Same level of LSCC

3. TYPE III Laterally placed to LSCC III a) Less than 2mm III b) More than 2mm

Study Timeline

• Study Start: 2010-01
• Primary Completion: 2016-09
• Status Verified: 2016-10
• Study Completion: 2016-10
• Study First Submitted: 2016-10-04
• Study First Submitted QC: 2016-10-04
• Study First Posted: 2016-10-05
• Last Update Submitted: 2016-10-05
• Last Update Posted: 2016-10-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 140

Inclusion Criteria

• All patient who underwent cochlear implant surgery with preoperative computed tomography scan and high resolution CT scan of temporal bone

Exclusion Criteria

• None

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Cochlear Implant	cochlear implant surgery	Patients with severe to profound sensorineural hearing loss who underwent cochlear implant surgery

Primary Outcome Measures

Name	Time	Method
Radiological classification of vertical segment of facial nerve	48 hours before surgery	- Radiological classification of vertical segment of facial nerve by studying temporal bone CT scan using an implemented scoring system; 1. TYPE I Medial to LSCC; 2. TYPE II Same level of LSCC; 3. TYPE III Laterally placed to LSCC III a) Less than 2mm III b) More than 2mm

Secondary Outcome Measures

Name	Time	Method
Surgical approach in cochlear implantation	For 4 hours after start of surgery	The surgical approach used for cochlear implantation

Trial Locations

Locations (1)

Dammam University KFHU; 🇸🇦 Al-Khobar, EP, Saudi Arabia