{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T22:19:48Z","timestamp":1786745988148,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We analyzed several radiological features of the facial recess to correlate them with the intraoperative findings to highlight the most reliable predictors of posterior tympanotomy difficulty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multicenter study at tertiary referral institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 184 pediatric patients who underwent cochlear implantation through the posterior tympanotomy approach. The correlation was attempted between 8\u00a0radiological features in the preoperative high\u2010resolution computed tomography scan and intraoperative surgical difficulty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Posterior tympanotomy was straightforward in 136 (73.9%) patients. In contrast, it was challenging in 48 (26.1%) patients. The facial recess was aerated in 74.5% of patients. The mean (SD) posterior tympanotomy depth was 3.98 (0.867) mm. The mean (SD) chorda\u2010facial angle was 27.67\u00b0 (3.406\u00b0). The mean (SD) chorda\u2010facial to stylomastoid length was 3.898 (0.6304) mm. The mean (SD) facial nerve second genu angle was 94.54\u00b0 (6.631)\u00b0. Deep\u2010unaerated facial recess wall was associated with the most difficulty. There was a statistically significant difference in the unchallenging and challenging posterior tympanotomy groups regarding the surgical duration (<jats:italic>P<\/jats:italic> &lt;. 0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>According to this analytic study, the chorda\u2010facial angle, the facial recess aeration, and the chorda\u2010facial to stylomastoid length were respectively the strongest preoperative radiological predictors of the surgical difficulty of posterior tympanotomy during cochlear implantation. Chorda\u2010facial angle &lt;25.5\u00b0 was associated with difficult posterior tympanotomy. The oblique parasagittal cut was essential for the radiological analysis of the facial recess.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221076998","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T12:14:04Z","timestamp":1644322444000},"page":"769-776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Radiological Analysis of the Facial Recess: Impact on Posterior Tympanotomy Difficulty During Pediatric Cochlear Implantation"],"prefix":"10.1002","volume":"167","author":[{"given":"Saad","family":"Elzayat","sequence":"first","affiliation":[{"name":"Otolaryngology Department Kafrelsheikh University Kafrelsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Mandour","sequence":"additional","affiliation":[{"name":"Otolaryngology Department Tanta University Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham 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