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

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

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.

Results

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.

Conclusion

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.

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Funding

There was no financial and material support for this study.

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Authors and Affiliations

  1. Department of Otolaryngology, Takanoko Hospital, Matsuyama, Ehime, Japan

    Shinya Miuchi, Masahiro Komori, Jun Hyodo, Daiki Takagi & Naoaki Yanagihara

  2. Department of Otolaryngology, Head and Neck Surgery, Hyogo College of Medicine, Mukogawa 1-1, Nishinomiya, 663-8501, Japan

    Shinya Miuchi & Masafumi Sakagami

  3. Department of Otolaryngology, Kochi Medical School, Kochi University, Nankoku, Japan

    Masahiro Komori

  4. Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Ehime University, Toon, Japan

    Daiki Takagi

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  1. Shinya Miuchi
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  2. Masahiro Komori
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  4. Daiki Takagi
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  5. Masafumi Sakagami
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  6. Naoaki Yanagihara
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Correspondence to Shinya Miuchi.

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Miuchi, S., Komori, M., Hyodo, J. et al. Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery. Eur Arch Otorhinolaryngol 276, 1617–1624 (2019). https://doi.org/10.1007/s00405-019-05399-4

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