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Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety

Human stapedius muscle (SM) can be directly and safely accessed via retrofacial approach, opening new approaches to directly measure the electrically evoked stapedius reflex threshold (eSRT). The measurement of the SM activity via direct surgical access represents a potential tool for objective eSRT...

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Autores principales: Guntinas-Lichius, Orlando, Arnold, Dirk, Volk, Gerd Fabian, Korth, Daniela, Aschenbach, Rene, Hempel, Johann-Martin, Schneider, Fritz, Schade-Mann, Thore, Gamerdinger, Philipp, Tropitzsch, Anke, Löwenheim, Hubert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371293/
https://www.ncbi.nlm.nih.gov/pubmed/35951500
http://dx.doi.org/10.1371/journal.pone.0272943
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author Guntinas-Lichius, Orlando
Arnold, Dirk
Volk, Gerd Fabian
Korth, Daniela
Aschenbach, Rene
Hempel, Johann-Martin
Schneider, Fritz
Schade-Mann, Thore
Gamerdinger, Philipp
Tropitzsch, Anke
Löwenheim, Hubert
author_facet Guntinas-Lichius, Orlando
Arnold, Dirk
Volk, Gerd Fabian
Korth, Daniela
Aschenbach, Rene
Hempel, Johann-Martin
Schneider, Fritz
Schade-Mann, Thore
Gamerdinger, Philipp
Tropitzsch, Anke
Löwenheim, Hubert
author_sort Guntinas-Lichius, Orlando
collection PubMed
description Human stapedius muscle (SM) can be directly and safely accessed via retrofacial approach, opening new approaches to directly measure the electrically evoked stapedius reflex threshold (eSRT). The measurement of the SM activity via direct surgical access represents a potential tool for objective eSRT fitting of cochlear implants (CI), increasing the benefit experienced by the CI users and leading to new perspectives in the development of smart implantable neurostimulators. 3D middle-ear reconstructions created after manual segmentation and related SM accessibility metrics were evaluated before the CI surgery for 16 candidates with assessed stapedius reflex. Retrofacial approach to access the SM was performed after facial recess exposure. In cases of poor exposition of SM, the access was performed anteriorly to the FN via drilling of the pyramidal eminence (PE). The total access rate of the SM via both the retrofacial and anterior approach of the FN was 100%. In 81.2% of cases (13/16), the retrofacial approach allowed to access the SM on previously categorized well exposed (8/8), partially exposed (4/5), and wholly concealed (1/3) SM with respect to FN. Following intraoperative evaluation in the remaining 18.8% (3/16), the SM was accessed anteriorly via drilling of the PE. Exposure of SM with respect to the FN and the sigmoid sinus’s prominence was a predictor for the suitable surgical approach. The retrofacial approach offers feasible and reproducible access to the SM belly, opening direct access to electromyographic sensing of the eSRT. Surgical planner tools can quantitatively assist pre-surgical assessment.
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spelling pubmed-93712932022-08-12 Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety Guntinas-Lichius, Orlando Arnold, Dirk Volk, Gerd Fabian Korth, Daniela Aschenbach, Rene Hempel, Johann-Martin Schneider, Fritz Schade-Mann, Thore Gamerdinger, Philipp Tropitzsch, Anke Löwenheim, Hubert PLoS One Research Article Human stapedius muscle (SM) can be directly and safely accessed via retrofacial approach, opening new approaches to directly measure the electrically evoked stapedius reflex threshold (eSRT). The measurement of the SM activity via direct surgical access represents a potential tool for objective eSRT fitting of cochlear implants (CI), increasing the benefit experienced by the CI users and leading to new perspectives in the development of smart implantable neurostimulators. 3D middle-ear reconstructions created after manual segmentation and related SM accessibility metrics were evaluated before the CI surgery for 16 candidates with assessed stapedius reflex. Retrofacial approach to access the SM was performed after facial recess exposure. In cases of poor exposition of SM, the access was performed anteriorly to the FN via drilling of the pyramidal eminence (PE). The total access rate of the SM via both the retrofacial and anterior approach of the FN was 100%. In 81.2% of cases (13/16), the retrofacial approach allowed to access the SM on previously categorized well exposed (8/8), partially exposed (4/5), and wholly concealed (1/3) SM with respect to FN. Following intraoperative evaluation in the remaining 18.8% (3/16), the SM was accessed anteriorly via drilling of the PE. Exposure of SM with respect to the FN and the sigmoid sinus’s prominence was a predictor for the suitable surgical approach. The retrofacial approach offers feasible and reproducible access to the SM belly, opening direct access to electromyographic sensing of the eSRT. Surgical planner tools can quantitatively assist pre-surgical assessment. Public Library of Science 2022-08-11 /pmc/articles/PMC9371293/ /pubmed/35951500 http://dx.doi.org/10.1371/journal.pone.0272943 Text en © 2022 Guntinas-Lichius et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Guntinas-Lichius, Orlando
Arnold, Dirk
Volk, Gerd Fabian
Korth, Daniela
Aschenbach, Rene
Hempel, Johann-Martin
Schneider, Fritz
Schade-Mann, Thore
Gamerdinger, Philipp
Tropitzsch, Anke
Löwenheim, Hubert
Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title_full Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title_fullStr Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title_full_unstemmed Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title_short Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety
title_sort accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: intraoperative results on feasibility and safety
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371293/
https://www.ncbi.nlm.nih.gov/pubmed/35951500
http://dx.doi.org/10.1371/journal.pone.0272943
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