Utility of preoperative computed tomography and magnetic resonance imaging in adult and pediatric cochlear implant candidates

Matthew Tamplen; Adam Schwalje; Lawrence Lustig; Aurash S Alemi; Mia E Miller

doi:10.1002/lary.25659

Utility of preoperative computed tomography and magnetic resonance imaging in adult and pediatric cochlear implant candidates

Laryngoscope. 2016 Jun;126(6):1440-5. doi: 10.1002/lary.25659. Epub 2015 Sep 11.

Authors

Matthew Tamplen¹, Adam Schwalje², Lawrence Lustig³, Aurash S Alemi¹, Mia E Miller⁴

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California.
² University of California San Francisco School of Medicine, San Francisco, California.
³ Department of Otolaryngology-Head and Neck Surgery, Columbia University, College of Physicians & Surgeons, New York, New York.
⁴ House Clinic, Los Angeles, California, U.S.A.

PMID: 26360798
DOI: 10.1002/lary.25659

Abstract

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.

Keywords: Cochlear implant; otology; pediatric otology; radiology.

Publication types

Evaluation Study

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cochlea / diagnostic imaging
Cochlea / surgery
Cochlear Implantation / methods*
Deafness / diagnostic imaging*
Deafness / surgery
Ear, Inner / diagnostic imaging
Ear, Inner / surgery
Female
Hearing Loss, Sensorineural / diagnostic imaging
Humans
Infant
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Predictive Value of Tests
Preoperative Care / methods*
Retrospective Studies
Temporal Bone / diagnostic imaging
Temporal Bone / surgery
Tomography, X-Ray Computed / methods*
Vestibular Aqueduct / abnormalities
Vestibular Aqueduct / diagnostic imaging
Young Adult

Supplementary concepts

Deafness, Autosomal Recessive 4