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Published in: European Archives of Oto-Rhino-Laryngology 6/2019

01-06-2019 | Computed Tomography | Otology

Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery

Authors: Shinya Miuchi, Masahiro Komori, Jun Hyodo, Daiki Takagi, Masafumi Sakagami, Naoaki Yanagihara

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2019

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Abstract

Purpose

Identification of the endolymphatic sac has failed occasionally. Postoperative complications have also rarely been reported. Given a safer and more reliable surgery, preoperative anatomical assessments are valuable, however, the vestibular aqueduct has seldom been seen with multi-planar reconstruction (MPR) computed tomography (CT) images yet. Our study aimed to determine the significance and utility of volume-rendered (VR) CT images of the surgical field for identifying the vestibular aqueduct, compared with MPR CT images.

Subjects and methods

14 patients with Meniere’s disease who underwent endolymphatic sac surgery between 2008 and 2011. Location and size of the vestibular aqueduct were assessed using VR and MPR CT images, independently.

Results

Accuracy of identifying the location differed significantly between VR and MPR CT images (rate of total correct evaluations: 100% by VR CT images vs 75% by MPR CT images, p = 0.02). Size was correctly identified in cases with a small endolymphatic sac using VR CT images (rate of total correct evaluations for size of the vestibular aqueduct: 100% by VR CT vs 57% by MPR CT, p = 0.046). VR CT images also demonstrated clearly the relationship between the endolymphatic sac and high jugular bulb. In two cases, the endolymphatic sac was identified by VR images, not by MPR images.

Conclusion

Accurate information about the location and size of vestibular aqueduct can allow sac surgeons to identify a tiny endolymphatic sac more easily and certainly, and also aids surgical trainees to learn sac surgery safely.
Appendix
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Metadata
Title
Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery
Authors
Shinya Miuchi
Masahiro Komori
Jun Hyodo
Daiki Takagi
Masafumi Sakagami
Naoaki Yanagihara
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 6/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05399-4

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