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Utility of preoperative computed tomography and magnetic resonance imaging in adult and pediatric cochlear implant candidates
Author(s) -
Tamplen Matthew,
Schwalje Adam,
Lustig Lawrence,
Alemi Aurash S.,
Miller Mia E.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25659
Subject(s) - cochlear implant , magnetic resonance imaging , computed tomography , medicine , implant , radiology , tomography , cochlear implantation , nuclear medicine , audiology , surgery
Objectives/Hypothesis Determine the utility of preoperative imaging in adult and pediatric cochlear implant candidates. Study Design Retrospective chart review. Methods Medical records of 101 consecutive adult and 20 consecutive pediatric patients who underwent 137 cochlear implantation (CI) procedures at a single institution were reviewed. Results Computed tomography (CT) was obtained preoperatively in 110 (90.9%) patients, preoperative magnetic resonance imaging (MRI) was obtained in 102 (84.3%) patients, and both were obtained in 94 (77.7%) patients. MRI revealed one acoustic neuroma and two meningiomas, which affected surgical planning for three (2.2%) procedures. MRI identified enlarged vestibular aqueduct (EVA) in 2.0% of adult patients. CT demonstrated middle ear disease in four (3.3%) patients. CT was useful in indicating round window and cochlear patency in three (2.2%) patients with cochlear otosclerosis. Twenty pediatric patients underwent 27 CI procedures. Preoperative CT in the pediatric cohort demonstrated five (25%) dysplastic cochleae, three (15%) dysplastic vestibules and/or semicircular canals, and three (15%) EVAs. In one patient, CT demonstrated a duplicated right internal auditory canal (IAC) and hypoplastic left IAC; MRI confirmed hypoplastic cochlear nerves. Conclusions Preoperative MRI can demonstrate retrocochlear pathology, cochlear patency, and EVA in adults being evaluated for cochlear implantation. CT may provide additional information in patients with chronic otitis media or otosclerosis. However, in postlingually deafened adults without conductive or asymmetrical hearing loss, imaging is unlikely to affect surgical decision making. Both CT and MRI can identify anomalies in pediatric patients. MRI does not offer substantial benefit over CT for routine evaluation of pediatric inner ear and temporal bone anatomy. Level of Evidence 4 Laryngoscope , 126:1440–1445, 2016