ABSTRACT
CONCLUSIONS: The round window membrane (RWM)-intentioned approach is superior to the traditional bony cochleostomy (BC) approach in obtaining electrode placement within the scala tympani (ST). OBJECTIVE: Cochlear implant outcome is influenced by several factors, including optimal placement and retention of the electrode array within the ST. The present study aimed to assess whether the RWM route is superior to a traditional BC for placement and retention of the electrode array in the ST. METHODS: This was a prospective consecutive non-randomized comparison study. All patients were implanted with the Advanced Bionics 1J electrode array. The RWM approach (n = 32) was compared with a traditional BC group (n = 33). The outcome measure was the electrode position as judged within the scalar chambers at four points along the basal turn using postoperative computed tomography (CT). RESULTS: When the mean position scores were compared, the RWM-intentioned group had significantly more electrodes directed towards the ST compartment than the BC group (p < 0.001). The RWM electrodes achieved 94% ST retention compared with 64% for the BC group (p < 0.05). All electrodes stayed in the ST in the RWM group, whereas in the BC group 9% crossed from the ST to the scala vestibuli.
Subject(s)
Cochlear Implantation/methods , Hearing Loss, Sensorineural/surgery , Round Window, Ear/surgery , Scala Tympani/surgery , Adolescent , Adult , Child , Child, Preschool , Cohort Studies , Electrodes, Implanted , Equipment Failure Analysis , Female , Hearing Loss, Sensorineural/diagnostic imaging , Humans , Image Interpretation, Computer-Assisted/methods , Male , Middle Aged , Postoperative Complications/diagnostic imaging , Prospective Studies , Radiographic Image Enhancement/methods , Round Window, Ear/diagnostic imaging , Scala Tympani/diagnostic imaging , Tomography, X-Ray Computed/methods , Young AdultABSTRACT
True malignant mixed tumours of the salivary gland (carcinosarcoma) are rare tumours composed of both carcinomatous and sarcomatous components. They predominantly occur in the parotid gland. This report presents the clinical, histological and imaging findings of a carcinosarcoma arising in the deep lobe of the parotid. We present magnetic resonance imaging (MRI) findings of this tumour. MRI demonstrated heterogenous intermediate T2-W signal with a thick irregular enhancing rim was suggestive of a malignant lesion.
Subject(s)
Carcinosarcoma/diagnosis , Parotid Neoplasms/diagnosis , Aged, 80 and over , Female , Humans , Magnetic Resonance Imaging/methodsABSTRACT
BACKGROUND: Cases with idiopathic intracranial hypertension (IIH) have been anecdotally found to demonstrate relatively short axial lengths on ultrasound A-scans. This finding has not been rigorously documented. We therefore systematically investigated globe shape in these cases using computed tomography. METHODS: Computed tomographic 0.625-mm sections of 10 cases with IIH and 10 control subjects were reformatted on a workstation. Globe lengths and widths were measured from axial reformats. Globe lengths and heights were measured from oblique sagittal reformats. Two masked observers took all the measurements. RESULTS: The mean axial lengths of the globes of cases with IIH were significantly shorter than those of controls (t test for independent samples, P<0.001). Both observers also found globe height to be significantly greater than globe length in oblique sagittal sections of cases with IIH compared with control subjects (Mann-Whitney U tests, P<0.01). The difference between length and width in axial sections was not different between cases with IIH and control subjects. Using a critical cutoff of 0.6-mm difference between globe height and length in oblique sagittal sections returned a sensitivity of 0.75 and a specificity of 0.75 for IIH detection from both right and left eyes. CONCLUSIONS: There are significant differences in globe shape and axial length between cases with IIH and control subjects. The differences in globe shape manifest significantly only in oblique sagittal sections. This imaging sign could be a useful marker for subclinical IIH.
