High-resolution computed tomography predicts optimal cochlear implantation strategy in patients with chronic otitis media

doi:10.4329/wjr.v18.i2.116610

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 2

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (67)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-2) series, Tables (1-1) series.

Item

Count

PDF

HTML

Figures (1-2)

Tables (1-1)

Sum=32

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=41

Feb 28, 2026 (publication date) through Feb 28, 2026

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Radiology

ISSN

1949-8470

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Radiol. Feb 28, 2026; 18(2): 116610
Published online Feb 28, 2026. doi: 10.4329/wjr.v18.i2.116610

High-resolution computed tomography predicts optimal cochlear implantation strategy in patients with chronic otitis media

Li-Jing Zhao, Yong Fu, Zhi-Li Zhang

Li-Jing Zhao, Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China

Li-Jing Zhao, Yong Fu, Department of Otorhinolaryngology Head and Neck Surgery, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents’ Health and Diseases, Hangzhou 310051, Zhejiang Province, China

Zhi-Li Zhang, Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310024, Zhejiang Province, China

Co-corresponding authors: Yong Fu and Zhi-Li Zhang.

Author contributions: Zhao LJ performed the data curation and formal analyses, and writing of the original draft; Fu Y served as the strategic and academic leader, providing the overarching conceptual vision, senior supervision, project administration, performed the conceptualization and supervision; Zhang ZL served as the technical and operational leader; conceived the study and methodology development; acquired the funding and necessary resources, and performed the surgery; Fu Y and Zhang ZL are designated as co-corresponding authors based on their synergistic and equally critical leadership, which operated at complementary strategic and operational levels, and wrote, reviewed, and edited the manuscript. Both authors jointly guided the research direction and manuscript preparation, and their partnership was indispensable to the project’s success.

Supported by the “Pioneer” and “Leading Goose” Research and Experimental Development Program of Zhejiang Province, No. 2025C01108.

Institutional review board statement: This study was reviewed and approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Approval No. 2025B IIT Ethics Approval No. 1088).

Informed consent statement: This retrospective study was deemed to involve no more than minimal risk to participants; therefore, the requirement for written informed consent was formally waived by the ethics committee, in accordance with relevant guidelines (Committee on Publication Ethics). General consent for treatment and the use of anonymized data for quality improvement and research had been obtained from all patients as part of the routine clinical care.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

Corresponding author: Zhi-Li Zhang, MD, PhD, Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 366 Wutong Road, Xihu District, Hangzhou 310024, Zhejiang Province, China. zhangzhili@zju.edu.cn

Received: November 17, 2025
Revised: December 28, 2025
Accepted: January 22, 2026
Published online: February 28, 2026
Processing time: 102 Days and 2.1 Hours

Abstract

BACKGROUND

Surgical strategies for cochlear implantation in patients with chronic otitis media (COM) are diverse and largely depend on the extent of the underlying pathology.

AIM

To develop a high-resolution computed tomography (HRCT)-based algorithm for guiding surgical strategy using correlations between imaging and operative findings.

METHODS

We retrospectively analyzed the preoperative HRCT scans of 12 consecutive adult patients (n = 12) with COM who underwent cochlear implantation. Specific radiological markers were evaluated, including soft tissue extension, scutum erosion, mastoid pneumatization, and cochlear ossification. These findings were systematically correlated with the necessary surgical procedure (canal wall-up vs canal wall-down/subtotal petrosectomy) and intraoperative findings.

RESULTS

Preoperative HRCT accurately predicted the necessary surgical approach in all cases in our cohort. Disease limited to the epitympanum with an intact posterior canal wall required a canal wall-up surgical approach (n = 7), whereas extensive soft tissue opacity involving the mastoid cavity necessitated a canal wall-down/subtotal petrosectomy approach (n = 5). HRCT achieved 100% sensitivity for detecting the single case of significant cochlear ossification in this preliminary series, allowing for appropriate preoperative planning. Postoperative computed tomography confirmed successful electrode placement in all cases. Clinical outcomes, including a low complication rate (one minor infection) and no disease recurrence, confirmed the accuracy of the imaging-based strategy.

CONCLUSION

Preoperative HRCT reliably predicts the required surgical approach in COM. The proposed imaging-based algorithm may help standardize planning for successful cochlear implantation.

Keywords: Diagnostic imaging; High-resolution computed tomography; Surgical planning; Cochlear implantation; Chronic otitis media

Core Tip: This study demonstrates that preoperative high-resolution computed tomography (HRCT) is a decisive tool for planning cochlear implantation in patients with chronic otitis media. Complete mastoid opacification on HRCT reliably predicts the need for radical surgery (canal wall-down/subtotal petrosectomy), whereas a clear mastoid permits a conservative (canal wall-up) approach. HRCT also accurately detects cochlear ossification, enabling crucial preoperative preparation. We propose a novel imaging-based decision algorithm to standardize surgical strategy, minimize intraoperative surprises, and optimize patient outcomes in these complex cases.