Morphologic Analysis of the Scala Tympani Using Synchrotron: Implications for Cochlear Implantation

Laryngoscope. 2024 Jun;134(6):2889-2897. doi: 10.1002/lary.31263. Epub 2024 Jan 8.

Abstract

Objectives: To use synchrotron radiation phase-contrast imaging (SR-PCI) to visualize and measure the morphology of the entire cochlear scala tympani (ST) and assess cochlear implant (CI) electrode trajectories.

Methods: SR-PCI images were used to obtain geometric measurements of the cochlear scalar diameter and area at 5-degree increments in 35 unimplanted and three implanted fixed human cadaveric cochleae.

Results: The cross-sectional diameter and area of the cochlea were found to decrease from the base to the apex. This study represents a wide variability in cochlear morphology and suggests that even in the smallest cochlea, the ST can accommodate a 0.4 mm diameter electrode up to 720°. Additionally, all lateral wall array trajectories were within the anatomically accommodating insertion zone.

Conclusion: This is the first study to use SR-PCI to visualize and quantify the entire ST morphology, from the round window to the apical tip, and assess the post-operative trajectory of electrodes. These high-resolution anatomical measurements can be used to inform the angular insertion depth that can be accommodated in CI patients, accounting for anatomical variability.

Level of evidence: N/A. Laryngoscope, 134:2889-2897, 2024.

Keywords: cochlear implant; cochlear morphology; scala tympani; synchrotron‐radiation phase‐contrast imaging (SR‐PCI).

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cadaver*
  • Cochlea / anatomy & histology
  • Cochlea / diagnostic imaging
  • Cochlea / surgery
  • Cochlear Implantation* / methods
  • Cochlear Implants*
  • Humans
  • Scala Tympani* / anatomy & histology
  • Scala Tympani* / surgery
  • Synchrotrons*