Radio-clinical assessment of crista fenestra during pediatric cochlear implantation

Objectives: This study aimed to assess the ability of preoperative computed tomography (CT) to predict the crista fenestra (CF) type during cochlear implantation and correlate these types with intraoperative findings. This may allow for precise preoperative planning with better surgical outcomes. Study design: A prospective observational study. Settings: The study was done in multiple tertiary centers between September 2021 and March 2024. Method: ology: We correlated the preoperative radiological type of the CF with the intraoperative CF type to evaluate the accuracy and sensitivity of the HRCT to predict the CF type. We also assessed the need for CF drilling in each case. Results: Our study included 154 patients who underwent CI. They were 90 (58.4 %) males and 64 (41.5 %) females with ages ranging from 2.1 to 7.6 years, with a mean of 4.69 ± 1.19. The intra-class correlation coefficient between both radiological evaluators was 0.985, which indicated a high agreement between them. The intraoperative surgical types of CF were significantly related to the radiological types as the Spearman correlation coefficient was 0.976, and the P-value was <0.001. Conclusions: Our study revealed that preoperative CT is a precise tool for predicting the intraoperative type of CF during cochlear implantation type with a sensitivity of 96.67 % and an accuracy of 94.17 %. Moreover, drilling of the CF is recommended in type A3 and type B2