{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:12:41Z","timestamp":1789560761316,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fundamental Research Funds for the Central Universities, Clinical Research 5010 Program, Sun Yat-sen University","award":["2024004"],"award-info":[{"award-number":["2024004"]}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515012436"],"award-info":[{"award-number":["2022A1515012436"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173154"],"award-info":[{"award-number":["82173154"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82471155"],"award-info":[{"award-number":["82471155"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,22]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Incomplete partition type III (IP-III) malformation presents unique challenges for cochlear implantation. We report a critical intraoperative imaging comparison in a paediatric IP-III case where traditional skull X-ray failed to reveal the precise location of the cochlear electrode, while high-resolution CT (HRCT) precisely identified the site of electrode displacement. This finding demonstrates a significant limitation of routine radiography in these complex anatomies. Our experience underscores HRCT\u2019s critical role in accurately verifying electrode placement for patients with IP-III. Recognising this imaging discrepancy is essential for preventing undiagnosed malposition, guiding surgical revision and optimising auditory outcomes. Our findings support considering intraoperative HRCT as a valuable adjunct for confirming electrode position in IP-III implantation. Further multicentre studies are warranted to establish evidence-based imaging protocols for this challenging patient group.<\/jats:p>","DOI":"10.1136\/bcr-2025-269858","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:17Z","timestamp":1789560017000},"page":"e269858","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative high-resolution CT reveals electrode misplacement undetected by skull X-ray following cochlear implantation for IP-III inner ear malformation"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3224-6595","authenticated-orcid":false,"given":"Zhen","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianci","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2708-1537","authenticated-orcid":false,"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Si","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026091605001142000_19.9.e269858.1","doi-asserted-by":"publisher","DOI":"10.1002\/cii.416"},{"key":"2026091605001142000_19.9.e269858.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0614-z"},{"key":"2026091605001142000_19.9.e269858.3","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/coa.13360","article-title":"Cochlear implants for patients with inner ear malformation: Experience in a cohort of 877 surgeries","volume":"44","author":"Shi","year":"2019","journal-title":"Clin Otolaryngol"},{"key":"2026091605001142000_19.9.e269858.4","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/MAO.0000000000003523","article-title":"Misplaced Cochlear Implant Electrodes Outside the Cochlea: A Literature Review and Presentation of Radiological and Electrophysiological Findings","volume":"43","author":"Cheung","year":"2022","journal-title":"Otol Neurotol"},{"key":"2026091605001142000_19.9.e269858.5","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1097\/MAO.0b013e3182a09cc3","article-title":"Value of routine plain x-ray position checks after cochlear implantation","volume":"34","author":"Dirr","year":"2013","journal-title":"Otol Neurotol"},{"key":"2026091605001142000_19.9.e269858.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1553413"},{"key":"2026091605001142000_19.9.e269858.7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1080\/14670100.2017.1403146","article-title":"Utility of intraoperative computed tomography for cochlear implantation in patients with difficult anatomy","volume":"19","author":"Kim","year":"2018","journal-title":"Cochlear Implants Int"},{"key":"2026091605001142000_19.9.e269858.8","doi-asserted-by":"crossref","first-page":"e460","DOI":"10.1097\/MAO.0000000000004222","article-title":"Management of Cochlear Implant Electrode Arrays Misplaced in the Internal Auditory Canal: A Systematic Review","volume":"45","author":"Johnson","year":"2024","journal-title":"Otol Neurotol"},{"key":"2026091605001142000_19.9.e269858.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0275543","article-title":"Systematic review of cochlear implantation in patients with inner ear malformations","volume":"17","author":"Shah","year":"2022","journal-title":"PLoS One"},{"key":"2026091605001142000_19.9.e269858.10","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1002\/lio2.1121","article-title":"Risk factors and management strategies of inadvertent facial nerve stimulation in cochlear implant recipients: A systematic review","volume":"8","author":"Alahmadi","year":"2023","journal-title":"Laryngoscope Investig Otolaryngol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:21Z","timestamp":1789560021000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,16]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-269858"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269858","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}