The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery

The treatment of total deafness using a cochlear implant has now become a routine medical procedure. The tendency to expand the audiological indications for cochlear stimulation and to preserve the remnants of hearing has brought new problems. The authors have studied the topographical anatomy of the internal structures of the ear in the area where cochleostomy is usually performed and an implant electrode inserted. Ten human temporal bones were obtained from cadavers and prepared in a formalin stain. After dissection of the bone in the area of round and oval windows, the following diameters were measured using a microscope with a scale: the transverse diameters of the cochlear and vestibular scalae at the level of the centre of the round window and 0.5 mm anteriorly to the round window, the distance between the windows and the distances from the end of the spiral lamina to the centre of the round window and to its anterior margin. The width of the cochlear scala at the level of the round window was 1.23 mm, and 0.5 mm anteriorly to the round window membrane it was 1.24 mm. The corresponding diameters for the vestibular scala are 1.34 and 1.27 mm. The distances from the end of the spiral lamina to the centre of the round window and to its anterior margin are 1.26 and 2.06 respectively. The authors noted that the two methods of electrode insertion show a difference of 2 mm in the length of the stimulated spiral lamina. The average total length of the unstimulated lamina is 2.06 and 4.06 in the two situations respectively