Skip to main content
SpringerLink
Log in

Implantation via the Round Window and Cochlear Hook Anatomy

  • Chapter
  • First Online:
Cochlear Anatomy via Microdissection with Clinical Implications

  • 781 Accesses

Abstract

The round window of the human cochlea shows significant anatomic variability, which can make its use as a portal for implant electrode insertion somewhat challenging. However, round window insertion is potentially less traumatic to inner ear structures than is electrode placement via a standard promontory cochleostomy. Round window insertion is now widely used in cases in which hearing preservation is the goal, and it is particularly well suited for placement of thin, straight electrode arrays intended to track the lateral wall of scala tympani.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Nomura Y. Otological significance of the round window. Adv Otorhinolaryngol. 1984;33:1–62.

    PubMed  CAS  Google Scholar 

  2. Su WY, Marion MS, Hinojosa R, Matz GL. Anatomical measurements of the cochlear aqueduct, round window membrane, round window niche, and facial recess. Laryngoscope. 1982;92:483–6.

    Article  CAS  PubMed  Google Scholar 

  3. Okuno H, Sando I. Anatomy of the round window: a histological study with a graphic reconstruction method. Acta Otolaryngol. 1988;106:55–63.

    Article  CAS  PubMed  Google Scholar 

  4. Cervera-Paz FJ, Linthicum FH, Manrique MJ, Perez N. Morphometry of the human cochlear wall and implications for cochlear surgery. Acta Otolaryngol. 2004;124:1124–30.

    Article  PubMed  Google Scholar 

  5. Roland PS, Wright CG, Isaacson B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope. 2007;117:1397–402.

    Article  PubMed  Google Scholar 

  6. Alzamil KS, Linthicum FH Jr. Extraneous round window membranes and plugs: possible effect on intratympanic therapy. Ann Otol Rhinol Laryngol. 2000;109:30–2.

    Article  CAS  PubMed  Google Scholar 

  7. Stewart TJ, Belal A. Surgical anatomy and pathology of the round window. Clin Otolaryngol. 1981;6:45–62.

    Article  CAS  PubMed  Google Scholar 

  8. Fujita T, Shin JE, Cunnane M, Fujita K, Henein S, Psaltis D, et al. Surgical anatomy of the human round window region: implications for cochlear endoscopy through the external auditory canal. Otol Neurotol. 2016;37:1189–94.

    Article  PubMed  Google Scholar 

  9. Aslan A, Gunhan K, Eskiizmir G, Elhan A. Anatomic observations on variations of the round window niche and its relationship to the tympanic membrane. J Int Adv Otol. 2006;2:52–7.

    Google Scholar 

  10. Souter MA, Briggs RJS, Wright CG, Roland PS. Round window insertion of precurved perimodiolar electrode arrays: how successful is it? Otol Neurotol. 2011;32:58–63.

    Article  PubMed  Google Scholar 

  11. Franz BKH, Clark GM, Bloom DM. Surgical anatomy of the round window with special reference to cochlear implantation. J Laryngol Otol. 1987;101:97–102.

    Article  CAS  PubMed  Google Scholar 

  12. Ishiyama A, Doherty J, Ishiyama G, Quesnel AM, Lopez I, Linthicum FH. Post hybrid cochlear implant hearing loss and endolymphatic hydrops. Otol Neurotol. 2016;37:1516–21.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Paprocki A, Biskup K, Kozlowska K, Kuniszyk A, Bien D, Niemczyk K. The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery. Folia Morph (Warsz). 2004;63:309–12.

    Google Scholar 

  14. Adunka O, Unkelbach MH, Mack M, Hambek M, Gstoettner W, Kiefer J. Cochlear implantation via the round window membrane minimizes trauma to cochlear structures: a histologically controlled insertion study. Acta Otolaryngol. 2004;124:807–12.

    Article  PubMed  Google Scholar 

  15. Richard C, Fayad JN, Doherty J, Linthicum FH Jr. Round window versus cochleostomy technique in cochlear implantation: histological findings. Otol Neurotol. 2012;33(7):1181.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Proctor B, Bollobas B, Niparko JK. Anatomy of the round window niche. Ann Otol Rhinol Laryngol. 1986;95:444–6.

    Article  CAS  PubMed  Google Scholar 

  17. Tóth M, Alpár A, Patonay L, Oláh I. Development and surgical anatomy of the round window niche. Ann Anat. 2006;188:93–101.

    Article  PubMed  Google Scholar 

  18. Marchioni D, Alicandri-Ciufelli M, Pothier DD, Rubini A, Presutti L. The round window region and contiguous areas: endoscopic anatomy and surgical implications. Eur Arch Otorhinolaryngol. 2015;272:1103–12.

    Article  PubMed  Google Scholar 

  19. Marchioni D, Soloperto D, Colleselli E, Tatti MF, Patel N, Jufas N. Round window chamber and fustis: endoscopic anatomy and surgical implications. Surg Radiol Anat. 2016;38:1013–9.

    Article  PubMed  Google Scholar 

  20. Bonali M, Anschuetz L, Fermi M, Villari D, Mariani GA, Manzoli L, et al. The variants of the retro- and hypotympanum: an endoscopic anatomical study. Eur Arch Otorhinolaryngol. 2017;274:2141–8.

    Article  PubMed  Google Scholar 

  21. Anson BJ, Bast TH. The development of the otic capsule in the region of the cochlear fenestra. Ann Otol Rhinol Laryngol. 1953;62:1083–116.

    Article  CAS  PubMed  Google Scholar 

  22. Wright CG, Halama AR, Meyerhoff WL. Ototoxicity of an ototopical preparation in a primate. Am J Otol. 1987;8:56–60.

    PubMed  CAS  Google Scholar 

  23. Schachern PA, Paparella MM, Duvall AJ III, Choo YB. The human round window membrane. An electron microscopic study. Arch Otolaryngol. 1984;110:15–21.

    Article  CAS  PubMed  Google Scholar 

Suggested Reading

  • Atturo F, Barbara M, Rask-Andersen H. Is the human round window really round? An anatomic study with surgical implications. Otol Neurotol. 2014;35:1354–60.

    Article  PubMed  Google Scholar 

  • Donaldson JA. Fossula of the cochlear fenestra. Arch Otolaryngol. 1968;88:32–8.

    Article  Google Scholar 

  • Havenith S, Lammers MJW, Tange RA, Trabalzini F, della Volpe A, van der Heijden GJ, et al. Hearing preservation surgery: cochleostomy or round window approach? A systematic review. Otol Neurotol. 2013;34:667–74.

    Article  PubMed  Google Scholar 

  • Li PMMC, Wang H, Northrop C, Merchant SN, Nadol JB Jr. Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol. 2007;28:641–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Proctor B. Surgical anatomy of the posterior tympanum. Ann Otol Rhinol Laryngol. 1969;78:1026–40.

    Article  CAS  PubMed  Google Scholar 

  • Singla A, Sahni D, Gupta AK, Loukas M, Aggarwal A. Surgical anatomy of round window and its implications for cochlear implantation. Clin Anat. 2014;27:331–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Charles G. Wright & Peter S. Roland

Authors
  1. Charles G. Wright
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter S. Roland
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wright, C.G., Roland, P.S. (2018). Implantation via the Round Window and Cochlear Hook Anatomy. In: Cochlear Anatomy via Microdissection with Clinical Implications. Springer, Cham. https://doi.org/10.1007/978-3-319-71222-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71222-2_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71221-5

  • Online ISBN: 978-3-319-71222-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation