This medical anatomical diagram and clinical illustration depict a hybrid cochlear implant system and its placement within the human ear. The image features a cross-sectional view of the ear anatomy and an inset showing the standalone hardware. External components include a behind-the-ear sound processor (1) connected to an earmould (3) in the external auditory canal (8) for acoustic amplification, and an external transmitter coil (2). Internal components include an implanted receiver/stimulator coil (4) and the main implant body (5) positioned subcutaneously. A flexible electrode array (6) is shown extending into the spiraled cochlea (7) of the inner ear. The diagram illustrates the dual mechanism of hybrid stimulation: electric stimulation of the auditory nerve via the intracochlear electrodes and acoustic amplification of low-frequency sounds through the earmould. Key landmarks include the external auditory meatus, tympanic membrane, ossicular chain, and the snail-shaped cochlea, demonstrating the pathway from sound capture to neural excitation.

This diagnostic image is a post-operative Computed Tomography (CT) scan of the right temporal bone, focused on the inner ear anatomy. The image demonstrates a cochlear implant in situ, following a primary implantation procedure. The electrode array is clearly visible as a curved, hyperdense (radiopaque) metallic structure positioned within the fluid-filled spaces of the cochlea. Specifically, the electrode is shown following the spiral trajectory of the basal turn, with an insertion depth of approximately 290 degrees. Key anatomical landmarks visible include the bony labyrinth of the cochlea, the mastoid process with its air cells, and the outline of the tympanic cavity. The image serves as an educational example of post-surgical verification for cochlear implant positioning, highlighting the spatial relationship between the prosthetic electrode and the delicate spiral architecture of the inner ear. It illustrates the clinical standard for assessing electrode array placement and ensuring correct anatomical orientation within the cochlear duct.

This composite educational graphic features two distinct medical images related to cochlear implant (CI) surgery in cases of inner ear malformations. The upper left diagnostic image is a high-resolution axial computerized tomography (CT) scan of the temporal bones with a teal-colored filter. It demonstrates a 'Common Cavity' malformation, characterized by a single confluent ovoid cystic space representing the vestibulocochlear organ, lacking a distinct cochlea and vestibule. The lower right image is an intraoperative clinical photograph showing a surgical site during mastoidectomy. The field is heavily obscured by an active 'gusher,' a significant outflow of cerebrospinal fluid (CSF) or perilymph from the cochleostomy, often associated with wide internal auditory canal connections in malformed ears. Visible in the surgical field are blood, exposed soft tissues, and white mesh-like packing or surgical sponges used to manage the fluid egress. These images highlight the diagnostic and intraoperative challenges faced during cochlear implantation in patients with complex inner ear anatomy.

This set of diagnostic images features coronal Cone-Beam Computed Tomography (CBCT) scans of the human petrous bone, comparing preoperative and postoperative states for cochlear implantation. The baseline image shows the native anatomy of the inner ear, including the spiral architecture of the cochlea and the surrounding temporal bone density. The postoperative images demonstrate the successful placement of a cochlear implant. A highly radio-opaque, coiled electrode array is clearly visible within the cochlear lumen, following the scalar tympani curve to stimulate the auditory nerve. Additionally, the surgical field shows evidence of mastoid cavity modification and the presence of filling materials (such as Bonalive or abdominal fat) used for site obliteration. These images serve as a clinical example of using intraoperative or immediate postoperative imaging to verify electrode positioning and surgical outcomes in patients with complex or altered temporal bone anatomy, facilitating high-resolution assessment of the relationship between the hardware and inner ear microstructures.

This diagnostic image is a Cone-Beam Computed Tomography (CBCT) paraaxial maximum intensity projection (MIP) focusing on the inner ear anatomy. It demonstrates a cochlear implant electrode array positioned within the cochlea. The electrode is visualized as a spiral series of hyperdense (bright), discrete contacts that follow the cochlear turns. A white arrowhead indicates a specific surgical complication: a basal fold-over. In this malposition, the proximal (basal) portion of the electrode array has bent or doubled back on itself within the basal turn of the cochlea, rather than following a smooth spiral insertion. This image is used in otolaryngology and radiology to evaluate post-operative cochlear implant placement and to identify mechanical insertion complications that can impact auditory outcomes. The CBCT modality provides high spatial resolution with reduced metal artifact compared to standard HRCT, allowing for detailed visualization of individual electrode contacts relative to the bony cochlear walls.

This diagnostic image provides a series of high-resolution CT slices through the petrosal bone, detailing the anatomy of the inner ear. The image set illustrates the complex three-dimensional structure of the bony labyrinth, with specific focus on the cochlea and vestibular apparatus. Slices 84 through 208 show the progressive coiling of the cochlea (co), revealing internal features such as the primary bony lamina (pl), cochlear canal (cn), and secondary bony lamina (sl). The relationship between the cochlea and the facial nerve canal (fn) is visible in the more anterior slices. Progressing posteriorly (slices 239–394), the vestibular system becomes prominent, showcasing the vestibule (vb), spherical recess (sr), and the three semicircular canals: anterior (ac), lateral (lc), and posterior (pc). Key landmarks for anatomical indexing include the fenestra cochleae (fc), fenestra vestibuli (fv), and the common crus (cr). These slices demonstrate the spatial orientation and morphology of the hearing and balance organs within the temporal bone, serving as a critical educational resource for understanding inner ear anatomy and radiological identification of its components.

This image presents a 3D computational reconstruction of the human inner ear, derived from a statistical shape model. The anatomical diagram demonstrates the complex three-dimensional relationship between the cochlea, vestibule, and semicircular canals. On the left, the spiral-shaped cochlea is clearly visible with its characteristic bulbous, snail-like winding. This transitions into the central vestibule, from which the three semicircular canals (superior, posterior, and lateral) originate. These canals are depicted as arched, looped structures oriented in nearly orthogonal planes, illustrating their physiological role in sensing rotational head movements. The model features a pale, textured surface, representing the bony labyrinth, set against a high-contrast black background. This visual serves as an educational tool for understanding otolaryngology and vestibular anatomy, particularly for medical students and clinicians studying diagnostic imaging segmentation or the pathophysiology of inner ear disorders like Meniere's disease.

This composite educational resource features high-resolution imaging of the human inner ear anatomy. Panels A-D display sequential axial CT images reformatted in the plane of the horizontal semicircular canal, progressing from an inferior to superior perspective. Black arrows highlight the distal vestibular aqueduct as it traverses the petrous temporal bone. The images demonstrate the spatial relationship between the bony labyrinth, including the vestibule and semicircular canals, and the vestibular aqueduct. Panels E and F provide 3D anatomical reconstructions (right and left views, respectively) illustrating the complex spatial morphology of these structures. The color-coding in the 3D models differentiates key components: the cochlea is shown in cyan, the vestibule and semicircular canals in yellow, and the vestibular aqueduct in dark blue. This visualization is intended to assist in the clinical assessment of inner ear pathologies, such as Meniere's disease or superior canal dehiscence syndrome, by mapping the trajectory and angle of the vestibular aqueduct relative to the labyrinthine structures.

This dual-panel image displays the anatomy of the human inner ear through histological and volumetric reconstruction. (A) A Hematoxylin and Eosin (H&E) stained histological section of the temporal bone in a parasagittal plane. It clearly shows the coiled architecture of the cochlea and vestibular components. A black arrow identifies the endolymphatic horizontal duct within the osseous space, highlighting the spatial ratio between the membranous and bony canals. A black diamond indicates a post-mortem promontorial cochleostomy, demonstrating endosteal layer injury and traumatic penetration of the scala tympani. (B) A micro-CT volumetric 3D reconstruction of the endolymphatic spaces within the membranous labyrinth. The model, rendered in pink, illustrates the integrated fluid-filled anatomy including the spiral cochlea, the utricle and saccule within the vestibule, and the three semicircular canals. This figure serves as an anatomical reference for inner ear pathology, specifically regarding endolymphatic hydrops and surgical access to the cochlear base.

Side-by-side intraoperative clinical photographs (A and B) showing a microscopic view of the right ear round window (RW) niche through a facial recess approach. Image A (pre-drilling) demonstrates the surgical anatomy following cortical mastoidectomy and posterior tympanotomy, with the round window partially obscured by a bony overhang. Key landmarks include the facial nerve (FN) located inferiorly, the chorda tympani nerve (CT) positioned distally, and a tissue wipe (TW) placed for moisture control. Image B (post-drilling) illustrates the 'extended round window technique,' where antero-inferior drilling of the bony margin and crista fenestrae has been performed to optimize exposure for cochlear implant electrode insertion. This surgical modification provides a clearer, more direct line of sight into the scala tympani. The anatomical relationship between the facial nerve and chorda tympani remains constant, serving as the borders of the facial recess through which the middle ear is accessed. This comparison is essential for surgical training in otology and cochlear implantation.

A series of three intraoperative clinical photographs showing a posterior tympanotomy (facial recess approach) in a right ear, a critical step in cochlear implant surgery. Panel A demonstrates a 2 mm surgical diamond burr positioned within the facial recess opening, serving as a scale to indicate adequate surgical dimensions for instrument access. Panels B and C highlight the critical anatomical landmarks surrounding the opening: the facial nerve (FN) is clearly identifiable on the posterior margin with an intact posterior external auditory canal wall, and the chorda tympani nerve (CTN) defines the anterior-superior border. Through the surgically created window, the round window (RW) is visualized posteroinferiorly, providing the target site for electrode insertion into the basal turn of the cochlea. The series illustrates a 'normal' surgical view where all anatomical boundaries are preserved and the round window is easily accessible for direct membrane insertion. This content is intended for otolaryngology surgical training and preoperative planning.

This composite of clinical and diagnostic images demonstrates the intraoperative validation of a minimally invasive cochlear implant (CI) surgical technique using a mini-stereotactic frame and patient-specific jigs. (A-E) Endoscopic and microscopic views of the facial recess (posterior tympanotomy) in multiple patients. The images show various sizes of sham drill bits (1.5 mm and 1.8 mm) being passed through the surgically exposed facial recess to evaluate the accuracy of a planned robotic trajectory. The surgical site displays anatomical landmarks including the facial nerve (FN) canal, chorda tympani, and the thinned external auditory canal (EAC). (F) A clinical photograph showing a titanium C-shaped mini-stereotactic frame fixated to a patient's skull posterior to the ear. The frame is secured via bone screws and holds a blue patient-specific positioning jig with fasteners. This assembly guides the drill path relative to the mastoidectomy site. The educational focus is on robotic-assisted otologic surgery, stereotactic navigation, and the spatial constraints of the facial recess during CI electrode insertion.