Oval Window Size and Shape: a Micro-CT Anatomical Study With Considerations for Stapes Surgery

Background: The oval window is an important structure with regard to stapes surgeries, including stapedotomy for the treatment of otosclerosis. Recent study of perioperative imaging of the oval window has revealed that oval window niche height can indicate both operative difficulty and subjective discomfort during otosclerosis surgery. With regard to shape, structures incorporated into the oval window niche, such as cartilage grafts, must be compatible with the shape of the oval window. Despite the clinical importance of the oval window, there is little information regarding its size and shape. Methods: This study assessed oval window size and shape via micro-computed tomography paired with modern morphometric methodology in the fetal, infant, child, and adult populations. Additionally, the study compared oval window size and shape between sexes and between left- and right-sided ears. Results: No significant differences were found among traditional morphometric parameters among age groups, sides, or sexes. However, geometric morphometric methods revealed shape differences between age groups. Further, geometric morphometric methods provided the average oval window shape and most-likely shape variance. Conclusion: Beyond demonstrating oval window size and shape variation, the results of this report will aid in identifying patients among whom anatomical variation may contribute to surgical difficulty and surgeon discomfort, or otherwise warrant preoperative adaptations for the incorporation of materials into and around the oval window. Address correspondence and reprint requests to Matthew J. Zdilla, D.C., Associate Professor of Biology and Physician Assistant Studies, Department of Natural Sciences and Mathematics, West Liberty University, CSC 139; P.O. Box 295, West Liberty, WV 26074. E-mail: mzdilla@westliberty.edu The research was carried out with the equipment purchased thanks to the financial support of the European Regional Development Fund in the framework of the Polish Innovation Economy Operational Program [contract no. POIG.02.01.00-12-023/08], the West Virginia IDeA Network for Biomedical Research Excellence [P20GM103434], and the NIH-NIAID [5K22AI087703]. The study was conducted with approval (KBET/198/B/2014) of the Bioethics Committee of the Jagiellonian University. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2i6WMKr). Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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