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MPR-CT Imaging for Stapes Prosthesis

Accuracy and Clinical Significance

Fang, Yanqing; Wang, Bing; Galvin, John J. III; Tao, Duoduo; Deng, Rui; Ou, Xiong; Liu, Yangwenyi; Dai, Peidong; Sha, Yan; Zhang, Tianyu; Chen, Bing

doi: 10.1097/MAO.0000000000000987
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Objectives: The aims of this article are: 1) to re-evaluate the accuracy of multiple planar reconstruction computed tomography (MPR-CT) imaging on stapes-prosthesis parameters, and 2) to clarify possible relationships between prosthesis intravestibular depth and postoperative hearing outcomes.

Patients: Seventy patients (46 women and 24 men; 32 right and 38 left sides) with the mean age of 40 years (range, 19–62 yr) with clinical otosclerosis.

Intervention(s): All patients underwent stapedotomy and were implanted with the same type of titanium piston prosthesis by the same surgeon.

Main Outcome Measure(s): Postoperative MPR-CTs were obtained at patients’ follow-up visits. The length and intravestibular depth of the stapes prosthesis (including absolute and relative depth) were calculated from the MPR-CT imaging. Relationships between the intravestibular depth of the prosthesis and hearing outcomes (pre- and postoperative audiograms) were analyzed using Spearman correlation analyses.

Results: The length of the prosthesis was overestimated by 1.8% (0.1 mm) by the MPR-CT imaging. Axial and coronal measurements were significantly correlated (p < 0.05). There was great intersubject variability in hearing outcomes differed insignificantly, regardless of intravestibular depth within the security range. No relationships were found between the intravestibular depth of the stapes prosthesis, as measured with MPR-CT, and postoperative hearing results.

Conclusions: MPR-CT can provide an accurate estimation of stapes prosthesis parameters. However, the prosthesis intravestibular depth did not seem to affect postoperative hearing outcomes.

*Department of Otology and Skull Base Surgery, Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China

Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, U.S.A.

Department of Ear Nose and Throat, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu

§Department of Radiology, Eye Ear Nose and Throat, Hospital of Fudan University, Shanghai, China

Address correspondence and reprint requests to Bing Chen, M.D., Shanghai, China; E-mail: bchen@citiz.net

Y.F. and B.W. are co-first authors.

No funding was received for this work from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), and other(s). The authors of this manuscript declare no relationship with any complication whose products or services may be related to the subject matter of the article. This work was partly supported by Shanghai Health and Family Planning Commission (artificial auditory rehabilitation technology popularization and clinical application for deafness; 2014ZYJB0005), National Natural Science Foundation of China (effects of spectral shift on multitalker speech recognition by cochlear implant users; 30872867), and Chinese Ministry of Health Resources’ Special Funds (the research and application of the early detection, diagnosis prevention, and control system for the major ear and nose disease; 201202005).

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