A study on modelling cochlear duct mid-scalar length based on high-resolution computed tomography, and its effect on peri-modiolar and mid-scalar implant selection

J Laryngol Otol. 2019 Sep;133(9):764-769. doi: 10.1017/S0022215119001671. Epub 2019 Aug 19.

Abstract

Objective: To determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length.

Methods: The study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the 'X' line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured.

Results: Cochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line.

Conclusion: Using the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.

Keywords: Cochlear Duct; Cochlear Implantation; Electrodes, Implanted; Radiographic Image Interpretation, Computer-Assisted; Tomography, Spiral Computed.