Otology & Neurotology最新文献

{"title":"Validation of a 3D-Printed Multimaterial Transcanal Tympanoplasty Simulator for Endoscopic Ear Surgery.","authors":"Stéphanie Rançon, Juliette Prebot, Françoise Denoyelle, Roman Hossein Khonsari, François Simon","doi":"10.1097/MAO.0000000000004546","DOIUrl":"10.1097/MAO.0000000000004546","url":null,"abstract":"<p><strong>Background: </strong>Simulation is an interesting tool to improve the learning curve of total endoscopic ear surgery (TEES), but hard 3D-printed temporal bones, and cadaveric or animal models have their limits. The objective of this study was to establish face, content, and construct validity for a new 3D-printed multimaterial transcanal tympanoplasty simulator.</p><p><strong>Methods: </strong>Temporal bone hard and soft tissues were segmented from an anonymized CT scan and 3D-printed using Polyjet multimaterial technology. Otolaryngology residents and TEES experts performed posterior perforation myringoplasty procedures on the simulator to assess face, content, and construct validity based on Likert scales. Residents also compared the model to cadaveric subjects.</p><p><strong>Results: </strong>Twelve residents and six experts gave overall 6.3/7 ± 1.4 and 6.0/7 ± 0.6 face validity scores ( p = 0.06) and overall 6.3/7 ± 0.8 and 6.0/7 ± 0.6 content validity scores ( p = 0.35), respectively. They indicated that the simulator should be incorporated into surgical training (6.5/7 ± 0.7 versus 5.5/7 ± 1.5; p = 0.17) and that it would be useful as a surgical competency evaluation tool (5.5/7 ± 0.8 versus 5.7/7 ± 1.4; p = 0.74). Overall satisfaction was similar to cadaveric subjects (3.7/7 ± 1.2). Construct validity, based on myringoplasty assessment scores for three experts, three fellows, and six residents, was 47.3/50 ± 0.6 versus 36.3/50 ± 3.2 versus 26.5/50 ± 5.3, respectively ( p = 0.009).</p><p><strong>Conclusion: </strong>The multimaterial tympanoplasty simulator met acceptable face, content, and construct validity scores. This opens a new field for simulation training in otology, moving on from temporal bone drilling to transcanal procedures including TEES.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e323-e329"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistent Visualization of the Round Window Niche Veil With Ultrahigh-Resolution Photon-Counting Detector CT.","authors":"Yu Si, Konstantin Klambauer, Thomas Flohr, Hatem Alkadhi, Alexander Huber, Merlin Schär","doi":"10.1097/MAO.0000000000004562","DOIUrl":"10.1097/MAO.0000000000004562","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether the ultrahigh-resolution (UHR) mode of photon-counting detector (PCD) CT can consistently visualize the round window niche veil (RWNV) in human ex vivo specimens.</p><p><strong>Samples: </strong>This ex vivo study was conducted on nine human cadaveric temporal bones (four male and five female body donors) with an average age of 72 years (range of 56-83 yr).</p><p><strong>Intervention: </strong>Imaging with a dual-source PCD-CT scanner in ultrahigh-resolution (UHR) mode.</p><p><strong>Main outcome measures: </strong>Two blinded, independent board-certified radiologists reviewed CT images in axial and coronal reformations to determine the presence and extent of an RWNV (complete or partial). The performance of the PCD-CT was evaluated by comparing the readings of the radiologists to inspection of the dissected specimens with a surgical endoscope and microscope.</p><p><strong>Results: </strong>The UHR mode of PCD-CT provided consistent visualization of the RWNVs. Five out of six RWNVs were accurately identified, and all three specimens without RWNVs were correctly recognized. All complete RWNVs were correctly identified. The readers missed one partial RWNV due to its close proximity and minimal fluid next to the round window membrane. The visualization of the RWNV was superior in the coronal plane compared with the axial plane.</p><p><strong>Conclusions: </strong>This study is the first to demonstrate that the UHR mode of PCD-CT enables a consistent visualization of the RWNV in ex vivo specimens. The promising results of the current study support verification of the results in prospective patient studies.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"944-948"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Chronicity and Severity of Tinnitus and Sleep-Related Issues.","authors":"Sang-Yoon Han, Hee Won Seo, Seung Hwan Lee, Jae Ho Chung","doi":"10.1097/MAO.0000000000004552","DOIUrl":"10.1097/MAO.0000000000004552","url":null,"abstract":"<p><strong>Objectives: </strong>Growing evidence suggests a potential link between tinnitus and sleep-related disturbances. This study aimed to explore this association in a large-scale population-based data.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>The 6,951 subjects with data on demographics, sleep patterns, sleep-related symptoms, and otologic assessments were selected from the eighth and ninth Korea National Health and Nutrition Examination Surveys (2019, 2020, and 2022), a database representing the general population.</p><p><strong>Main outcomes measures: </strong>Subjects were classified into tinnitus and nontinnitus groups, with the tinnitus group subdivided by chronicity (acute/chronic) and severity (mild/severe), and their association with sleep issues was analyzed.</p><p><strong>Results: </strong>The chronic tinnitus group had shorter sleep durations (weekdays, p < 0.001; weekends, p < 0.001) and higher proportions of sleep deprivation (weekdays, p = 0.001; weekends, p < 0.001), fatigue ( p < 0.001), and witnessed obstructive sleep apnea ( p = 0.026) compared to the nontinnitus group. They also exhibited shorter sleep duration ( p = 0.027) and more sleep deprivation ( p = 0.025) on weekends than the acute tinnitus group. The severe tinnitus group showed shorter sleep durations (weekdays, p = 0.004; weekends, p = 0.002), more sleep deprivation (weekdays, p = 0.025; weekends, p = 0.001), and higher levels of fatigue ( p = 0.001) compared to the nontinnitus group, as well as more fatigue than the mild tinnitus group ( p = 0.036).</p><p><strong>Conclusion: </strong>The chronicity and severity of tinnitus were significantly associated with sleep problems. Chronic and severe tinnitus are strongly associated with sleep disturbances, emphasizing the need for targeted management.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"991-997"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Achieving a Definitive Diagnosis of External Auditory Canal Squamous Cell Carcinoma.","authors":"Noritaka Komune, Ryosuke Kuga, Yutaro Kida, Tomomi Manako, Rika Harada, Shogo Masuda, Teppei Noda, Nozomu Matsumoto, Takashi Nakagawa","doi":"10.1097/MAO.0000000000004559","DOIUrl":"10.1097/MAO.0000000000004559","url":null,"abstract":"<p><strong>Objective: </strong>Squamous cell carcinoma (SCC) of the external auditory canal has a favorable prognosis when complete resection with negative margins is achieved. Early diagnosis and timely referral to specialized centers are crucial. However, definitive diagnosis is often delayed due to challenges in timely referral and the need for multiple biopsies. This study aims to examine the diagnostic trajectory of SCC of the external auditory canal, focusing on the number of biopsies required and the process leading to definitive diagnosis.</p><p><strong>Study design: </strong>Retrospective case review and descriptive study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>We conducted a retrospective case review at a tertiary referral center, analyzing 56 cases of SCC of the external auditory canal treated between January 2015 and February 2024.</p><p><strong>Interventions: </strong>Medical records were retrospectively reviewed.</p><p><strong>Main outcome measures: </strong>The course of events leading up to their visit of our hospital, the number of biopsies performed to be diagnosed, and the histopathological findings.</p><p><strong>Results: </strong>The time from initial presentation to referral ranged from 1 to 785 days (mean: 170.6 d; median: 130 d). A definitive diagnosis was achieved with the first biopsy in 35 cases (62.5%), whereas 21 cases (37.5%) required multiple biopsies. Only 21.4% of the cases were definitively diagnosed at the initial presenting facility, whereas 32.1% were diagnosed at our hospital. More than 90% of the tumors were well-differentiated or well-to moderately/poorly differentiated SCC. The number of biopsies required to confirm a definitive diagnosis was significantly associated with longer delays in hospital referral (correlation coefficient: 0.3122, p = 0.0192). Two cases of the hyperkeratotic SCC were presented as representative cases in which a definitive diagnosis was challenging.</p><p><strong>Conclusion: </strong>Early diagnosis of SCC of the external auditory canal relies on thorough biopsy evaluation. Given the tumor's tendency for high differentiation, obtaining biopsy samples with clear malignant features is critical for making an accurate and timely definitive diagnosis.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"972-977"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Surgeon Experiences With a Robotic-Assisted Cochlear Implant Electrode Array Insertion System.","authors":"Rick F Nelson, Amanda R Ernst, Oliver Adunka, S Babu, Matthew L Carlson, Alexander D Claussen, Nicholas L Deep, Bruce J Gantz, Jay A Gantz, Richard Gurgel, Robert Hong, Xiaoyang Hua, Daniel Lee, Neil Patel, Felipe Santos, Charles Yates, Marlan R Hansen","doi":"10.1097/MAO.0000000000004554","DOIUrl":"10.1097/MAO.0000000000004554","url":null,"abstract":"<p><strong>Objective: </strong>To assess integration of a single-use robotic-assisted cochlear implant (RA-CI) electrode array insertion system into surgical workflows, identify potential challenges, and inform best practices.</p><p><strong>Study design: </strong>Survey.</p><p><strong>Setting: </strong>Survey data from 16 surgeons across 10 US hospitals.</p><p><strong>Patients: </strong>CI candidates 12 years and older with radiographically normal cochleae.</p><p><strong>Intervention: </strong>CI surgery with single-use RA-CI insertion system during electrode array insertion.</p><p><strong>Main outcome measures: </strong>Number of RA-CI to achieve proficiency, estimated additional time for RA-CI, and best practices to successfully incorporate the RA insertion system into CI surgery.</p><p><strong>Results: </strong>A total of 121 RA-CI cases were performed. All surgeons completed the survey. Most surgeons (62.5%) reported they would feel comfortable using the device within five cases. Eight (50%) reported use of the RA system added 5 to 10 minutes to the case, and seven (44%) reported an added 10-15 minutes. Providing adequate incision size to secure the unit base superior to the temporal line and maximizing exposure of the facial recess were the most recommended best practices. Additional recommendations included pulling the receiver/stimulator forward within the pocket to facilitate a full electrode array insertion and considering drive head placement and mastoidectomy size to maximize overall visibility during electrode array insertion.</p><p><strong>Conclusions: </strong>Proficiency with an RA electrode array insertion system during CI surgery can be achieved with minor adjustments to the surgical approach, within relatively few use cases (generally <5) and with minimal time addition (between 5 and 15 min). Training to specific best practices is important before initial clinical use.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"924-932"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Minimum Neurotology Fellowship Case Numbers: A Survey of American Neurotology Society Members.","authors":"Edward Harwick, Walter Kutz, Karl Doerfer, Rick F Nelson, Maura Cosetti, Robert Hong, Deepa Galaiya, Tina Huang, Jacques Herzog, Oliver Adunka, Michael S Harris","doi":"10.1097/MAO.0000000000004570","DOIUrl":"10.1097/MAO.0000000000004570","url":null,"abstract":"<p><strong>Objective: </strong>Compare the Accreditation Council for Graduate Medical Education (ACGME) Neurotology Minimum Number case requirements for graduating neurotology fellows with what American Neurotology Society (ANS) members believe to be the number of cases needed to achieve competency and other clinically relevant benchmarks.</p><p><strong>Methods: </strong>An anonymous Internet-based ratio scale survey of current ANS members to assess 1) respondents' demographic and practice characteristics (e.g., years in practice, practice environment); 2) self-reflection estimates regarding fellowship case numbers needed to achieve surgical competency and case numbers post-training needed to achieve key benchmarks (current case duration, outcomes comparable to the literature); and 3) opinions on what minimum case numbers should be for conventional lateral skull base approaches.</p><p><strong>Results: </strong>A total of 143 ANS members (24% response rate) completed the survey, representing both academic and private practice neurotology and a broad range of years in practice. To achieve competency, respondents reported needing approximately 20 translabyrinthine approaches, 15 retrosigmoid approaches, 18 middle cranial fossa (MCF) approaches for tumors, and 13 MCF approaches for non-neoplastic indications each. Most (85%) respondents believed the translabyrinthine approach should be assigned a minimum case number requirement. A substantial proportion of respondents (21-31%) reported rarely or never using the MCF approach for vestibular schwannoma resection.</p><p><strong>Conclusion: </strong>For any single lateral skull base approach, ANS members' responses fell within the ACGME's current 25-case minimum. Cumulatively, however, for competency in multiple conventional approaches coming out of fellowship, these data may suggest that more cases are necessary. Additionally, making a specific requirement for translabyrinthine approach should be considered.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"877-883"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Case of the Month: Differentiating Intraosseous Dural Arteriovenous Fistula and Jugular Paraganglioma.","authors":"Prishae Wilson, Estephania Candelo, Patricia A Rhyner, Thien J Huynh, Mallory J Raymond","doi":"10.1097/MAO.0000000000004563","DOIUrl":"10.1097/MAO.0000000000004563","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1000-1001"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Testosterone and Dehydroepiandrosterone Sulfate Levels and Hearing Loss in Older Males: The Hitachi Health Study II.","authors":"Aoi Ito, Shohei Yamamoto, Yosuke Inoue, Ami Fukunaga, Maki Konishi, Katsuyuki Ohara, Shuichiro Yamamoto, Tohru Nakagawa, Tetsuya Mizoue","doi":"10.1097/MAO.0000000000004577","DOIUrl":"10.1097/MAO.0000000000004577","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the association of serum testosterone and dehydroepiandrosterone sulfate levels with hearing loss in older males.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>A health care center.</p><p><strong>Patients: </strong>This study included 1,421 males aged 60 to 69 yrs who participated in the baseline survey of the Hitachi Health Study II.</p><p><strong>Exposures: </strong>Serum testosterone and DHEAS levels were measured using chemiluminescence and chemiluminescent enzyme immunoassays, respectively.</p><p><strong>Main outcome measures: </strong>Pure-tone audiometric testing was performed to identify hearing loss at 1 and 4 kHz.</p><p><strong>Results: </strong>Higher serum testosterone levels were associated with lower odds of hearing loss at 4 kHz. The OR (95% CI) of hearing loss was 0.71 (0.50, 0.999) for the highest compared with that for the lowest quartile of serum testosterone. A dose-response association was also found between serum testosterone levels and hearing loss at 4 kHz ( P for linearity = 0.01). No association was found between serum testosterone levels and hearing loss at 1 kHz (OR for the highest vs lowest quartiles of serum testosterone = 1.06). Serum dehydroepiandrosterone sulfate levels were not associated with hearing loss: the ORs (95% CI) for the highest compared with that for the lowest quartile were 1.01 (0.64, 1.61) and 0.81 (0.58, 1.14) for 1 and 4 kHz, respectively.</p><p><strong>Conclusion: </strong>Our findings suggest that older males with higher serum testosterone levels were less likely to have high-frequency hearing loss.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e342-e348"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Obesity with Safety and Efficacy of Middle Cranial Fossa Repair of Spontaneous Cerebrospinal Fluid Leaks.","authors":"Hunter L Elms, Douglas J Totten, William R Schneider, Charles W Yates, Evan C Cumpston, Rick F Nelson","doi":"10.1097/MAO.0000000000004621","DOIUrl":"10.1097/MAO.0000000000004621","url":null,"abstract":"<p><strong>Objective: </strong>Determine if class 3, morbid obesity (body mass index, BMI >40 kg/m2) patients have increased risk of complications following middle cranial fossa (MCF) repairs of spontaneous cerebrospinal fluid leaks (sCSF-Ls).</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Tertiary academic.</p><p><strong>Patients: </strong>Adults (>18 yrs old) with temporal bone CSF leak.</p><p><strong>Interventions: </strong>Middle fossa craniotomy CSF leak repair.</p><p><strong>Main outcome measures: </strong>Comparison of perioperative complications according to American Surgical Association severity (grades 1-5) and rates of ipsilateral persistent leak within 90 days of initial surgery across obesity classes.</p><p><strong>Results: </strong>A total of 124 patients (64.5% female) with a mean (SD) age of 57 (11.3) years (range, 28-81) underwent MCF repairs of 142 spontaneous temporal bone leaks. Of these, 49.2% were right sided, 36.3% were left sided, and 14.5% were bilateral. The mean (SD) BMI was 38.1 (11.9) kg/m2 [range, 23.6-85.4 kg/m2], and the distribution of BMI categories was as follows: normal (2.4%), overweight (11.3%), class 1 obese (22.5%), class 2 obese (21.8%), class 3 obese (41.9%). Successful initial surgical repair was 97.2%, the mean length of stay was 2.4 (1.2) days, and 93.0% of patients experienced no complications. There was no difference in complication rates or severity scores, length of stay, or rates of persistent CSF leak across BMI categories.</p><p><strong>Conclusions: </strong>Of sCSF-L patients, 41.9% have class 3 obesity, and MCF repair can be performed in this population at experienced centers with high success rates and few complications.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Assessment of the Round Window Anatomy in Pediatric Patients Relevant to Gene Therapy and Inner Ear Drug Delivery.","authors":"Renata M Knoll, Soomin Myoung, Zachary A Kons, Katherine L Reinshagen, Judith S Kempfle","doi":"10.1097/MAO.0000000000004623","DOIUrl":"10.1097/MAO.0000000000004623","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the anatomical diversity of the round window (RW) in the pediatric population, focusing on its transcanal trajectory and anatomical angles. The study aims to provide insights into how RW accessibility changes with age, which may impact surgical planning and drug delivery approaches.</p><p><strong>Study design: </strong>Retrospective radiologic review of pediatric patients who underwent high-resolution CT scans of the temporal bone.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Ninety-one pediatric ears from 50 patients with normal anatomy between the ages of 0 and 15 years were analyzed.</p><p><strong>Interventions: </strong>Radiologic measurements: Using OsiriX MD, scans were reformatted to measure RW access angles, depth, and volume. Using 3D Slicer for 3D reconstruction, RW niche segmentation and volumetric analysis were performed.</p><p><strong>Main outcome measures: </strong>Main outcome measures included evaluation of transcanal angle to the RW membrane, depth and opening angle of the RW, volume and shape variability, and its three-dimensional localization relative to the umbo.</p><p><strong>Results: </strong>The results demonstrated that the mean transcanal angle to the RW membrane was 98.8° ± 7°. The transcanal angle to the RW increased significantly with age, with the ≥24-month age group demonstrating a mean increase of 6.2° compared to the younger cohort (p < 0.0001). Additionally, the RW position was found to shift inferiorly as age increased, with a mean difference of 0.47 mm (p = 0.01).</p><p><strong>Conclusions: </strong>This study provides valuable anatomical insights into changing pediatric RW morphology. These results may have implications for future surgical approaches, particularly for transcanal drug delivery and gene therapy in pediatric patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}