{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:04:33Z","timestamp":1780639473576,"version":"3.54.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To better characterize the cochlear apex in relation to surgically relevant landmarks to guide surgeons and improve procedural success of apical electrode placement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Study Design:<\/jats:title>\n            <jats:p>Retrospective image analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Tertiary referral center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Cochlear implant recipients with available preoperative computed tomography (CT) imaging.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>None.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measure:<\/jats:title>\n            <jats:p>Cochlear dimensions and cochlear apex distance measures to surgically relevant middle ear landmarks and critical structures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Eighty-two temporal bone CT scans were analyzed utilizing multiplanar reformats. The average lateral width of promontory bone over the cochlear apex was 1.2\u2009mm (standard deviation [SD], 0.3). The anteroposterior distance from the round window (avg, 4.2\u2009mm; SD, 0.5), oval window (avg, 3.3\u2009mm; SD, 0.3), cochleariform process (avg, 2.3; SD, 0.5), and superior-inferior distance from the cochleariform process (avg, \u22120.9; SD, 0.8) to the cochlear apex were measured. The relationship of the cochlear apex to critical structures was highly variable.<\/jats:p>\n            <jats:p>A newly developed stapes vector was created and found to mark the posterior\/superior boundary of the apex in 94% of patients. When a vector parallel to the stapes vector was drawn through the round window, it marked the anterior\/inferior boundary of the cochlear apex in 89% of patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>This study assists in characterizing cochlear apex anatomy and its relation to surrounding structures as a means of improving procedural accuracy and reducing trauma during apical cochleostomy. Understanding both distance relationships and expected boundaries of the apex could help to inform future surgical approaches.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ono.0000000000000060","type":"journal-article","created":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T03:41:32Z","timestamp":1724470892000},"page":"e060","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Cochlear Apex Triangulation Utilizing Ct Measures And Middle Ear Landmarks"],"prefix":"10.1097","volume":"4","author":[{"given":"Justin","family":"Cottrell","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Landsberger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Breen","sequence":"additional","affiliation":[{"name":"Department of Radiology, NYU Langone, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Lebowitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Radiology, NYU Langone, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gul","family":"Moonis","sequence":"additional","affiliation":[{"name":"Department of Radiology, NYU Langone, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Friedmann","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Jethanamest","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McMenomey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, NYU Langone, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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