European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 6, pp 1617–1624 | Cite as

Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery

  • Shinya MiuchiEmail author
  • Masahiro Komori
  • Jun Hyodo
  • Daiki Takagi
  • Masafumi Sakagami
  • Naoaki Yanagihara



Identification of the endolymphatic sac has failed occasionally. Postoperative complications have also rarely been reported. Given a safer and more reliable surgery, preoperative anatomical assessments are valuable, however, the vestibular aqueduct has seldom been seen with multi-planar reconstruction (MPR) computed tomography (CT) images yet. Our study aimed to determine the significance and utility of volume-rendered (VR) CT images of the surgical field for identifying the vestibular aqueduct, compared with MPR CT images.

Subjects and methods

14 patients with Meniere’s disease who underwent endolymphatic sac surgery between 2008 and 2011. Location and size of the vestibular aqueduct were assessed using VR and MPR CT images, independently.


Accuracy of identifying the location differed significantly between VR and MPR CT images (rate of total correct evaluations: 100% by VR CT images vs 75% by MPR CT images, p = 0.02). Size was correctly identified in cases with a small endolymphatic sac using VR CT images (rate of total correct evaluations for size of the vestibular aqueduct: 100% by VR CT vs 57% by MPR CT, p = 0.046). VR CT images also demonstrated clearly the relationship between the endolymphatic sac and high jugular bulb. In two cases, the endolymphatic sac was identified by VR images, not by MPR images.


Accurate information about the location and size of vestibular aqueduct can allow sac surgeons to identify a tiny endolymphatic sac more easily and certainly, and also aids surgical trainees to learn sac surgery safely.


Meniere’s disease Endolymphatic sac Cone-beam CT Volume-rendering technique Three-dimensional image 



There was no financial and material support for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (WMV 7948 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OtolaryngologyTakanoko HospitalMatsuyamaJapan
  2. 2.Department of Otolaryngology, Head and Neck SurgeryHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of Otolaryngology, Kochi Medical SchoolKochi UniversityNankokuJapan
  4. 4.Department of Otolaryngology, Head and Neck Surgery, School of MedicineEhime UniversityToonJapan

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