*Article* **Anatomical Variations of the Human Cochlea Using an Image Analysis Tool**

**Raabid Hussain 1,\*, Attila Frater 1, Roger Calixto 1, Chadlia Karoui 2, Jan Margeta 3, Zihao Wang 4, Michel Hoen 2, Herve Delingette 4, François Patou 1, Charles Raffaelli 5, Clair Vandersteen <sup>5</sup> and Nicolas Guevara <sup>5</sup>**


**Abstract:** Understanding cochlear anatomy is crucial for developing less traumatic electrode arrays and insertion guidance for cochlear implantation. The human cochlea shows considerable variability in size and morphology. This study analyses 1000+ clinical temporal bone CT images using a webbased image analysis tool. Cochlear size and shape parameters were obtained to determine population statistics and perform regression and correlation analysis. The analysis revealed that cochlear morphology follows Gaussian distribution, while cochlear dimensions A and B are not well-correlated to each other. Additionally, dimension B is more correlated to duct lengths, the wrapping factor and volume than dimension A. The scala tympani size varies considerably among the population, with the size generally decreasing along insertion depth with dimensional jumps through the trajectory. The mean scala tympani radius was 0.32 mm near the 720◦ insertion angle. Inter-individual variability was four times that of intra-individual variation. On average, the dimensions of both ears are similar. However, statistically significant differences in clinical dimensions were observed between ears of the same patient, suggesting that size and shape are not the same. Harnessing deep learning-based, automated image analysis tools, our results yielded important insights into cochlear morphology and implant development, helping to reduce insertion trauma and preserving residual hearing.

**Keywords:** cochlear morphology; cochlear implantation; statistical analysis
