The Journal of International
Advanced Otology
Original Article

Localization of the Vertical Part of the Facial Nerve in the High-Resolution Computed Tomography During Pediatric Cochlear Implantation


Department of Otorhinolaryngology, Tanta University, Faculty of Medicine, Tanta, Egypt


Department of Otorhinolaryngology, Kafrelsheikh University, Faculty of Medicine, Kafrelsheikh, Egypt


Department of Department of Neuroscience, Mental Health and Sense Organs NESMOS, Sapienza University, Rome, Italy


Department of Neuroscience, Mental Health and Sensory Organs, Sant’ Andrea University Hospital, Sapienza University, Faculty of Medicine and Psychology, Rome, Italy


Department of Radiology, Tanta University, Faculty of Medicine, Tanta, Egypt

J Int Adv Otol 2024; 20: 8-13
DOI: 10.5152/iao.2024.231212
Read: 416 Downloads: 148 Published: 01 February 2024

BACKGROUND: This study proposed a classification of the vertical portion of the facial nerve (VPFN) location, incorporating the previous classifications regarding the posterior-to-anterior and medial-to-lateral dimensions. We also evaluated the implication of this proposed classification on the round window visibility during pediatric cochlear implantation (CI).

METHODS: It was a retrospective multicenter observational cohort study. This study included 334 cases that underwent CI between 2015 and 2022 at multiple referral institutes. Two physicians evaluated the preoperative computed tomography images of 334 patients and determined the radiological type of the VPFN. These types were matched with intraoperative round window accessibility.

RESULTS: The Spearman’s correlation coefficient showed a strong correlation between the proposed VPFN type and the intraoperative round window visibility, as the P-value was <.001.

CONCLUSION: This classification could provide the surgeon preoperatively with the precise location of the VPFN in the lateral-to-medial and posterior-to-anterior dimensions. Furthermore, this location classification of the VPFN was significantly correlated with intraoperative round window accessibility, with an accuracy of 90.42%. Therefore, types C and D were expected to have difficult accessibility into the round window, and more surgical interventions were needed to modify the posterior tympanotomy or use other approaches.

Cite this article as: Mandour M, Amer M, Elzayat S, et al. Localization of the vertical part of the facial nerve in the high-resolution computed tomography during pediatric cochlear implantation. J Int Adv Otol. 2024;20(1):8-13.

EISSN 2148-3817