Cochlear Implantation in Children with Anomalous Cochleovestibular Anatomy: Our Experience

Grover, Mohnish; Sharma, Shitanshu; Bhargava, Shruti; Singh, Suresh; Gupta, Gaurav; Sharma, Malvika

doi:10.1007/s12070-017-1209-z

Cited by 15 publications

(27 citation statements)

References 12 publications

(14 reference statements)

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“…Early on in the protocol, all cochleovestibular anomalies detected on MRI would receive HRCT including IP2. Although HRCT would be indicated to complete diagnostic evaluation by our neuroradiologist, in the absence of a concurrent craniofacial syndrome, it is very rare that an abnormal facial nerve is present with an IP2 cochleovestibular anomaly . Therefore, it was determined that such imaging was not required to facilitate a safe and efficient surgical approach.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

et al. 2019

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Objectives/Hypothesis: There is no consensus on the necessary preoperative imaging in children being evaluated for cochlear implantation (CI). Dual-imaging protocols that implement both magnetic resonance imaging (MRI) and high resolution computed tomography (HRCT) create diagnostic redundancy in the face of potentially unnecessary radiation and anaesthetic exposure. The objectives of the current study were to examine the efficacy of an MRI-predominant with selective HRCT imaging protocol.Study Design: Retrospective review. Methods: The protocol was implemented over a 4-year period, during which HRCT was obtained in addition to MRI only if specific risk factors on clinical assessment were identified or if imaging findings in need of further evaluation were detected on initial MRI evaluation. Retrospective review of operative reports and prospective review of imaging were performed; anesthetic exposure and costing information were also obtained.Results: Of the 240 patients who underwent assessment, seven (2.9%) had combined HRCT and MRI performed concurrently based on initial clinical assessment, 15 (6.3%) underwent HRCT based on imaging anomalies found on MRI, and MRI alone was ordered for the remaining 218 (90.1%). All patients were implanted without complication. Overall, radiation exposure, general anesthesia (GA), and healthcare costs were reduced.Conclusions: MRI alone can be used in the vast majority of cases for preoperative evaluation of pediatric CI candidates resulting in a significant reduction in healthcare costs, radiation, and GA exposure in children. The additional need for HRCT occurs in a small proportion and can be predicted up front on clinical assessment or on initial MRI.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

et al. 2019

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“…Several ways of controlling an intraoperative gusher have been reported; the most common way is to wait until the gusher stops, insert the array, and meticulously pack the cochlear opening with muscle, fascia, and sometimes also fibrin glue 5 , 7 , 13 , 14 or, in cases of severe malformation, fat tissue instead of muscle. 14 Indeed, this method continues to be used because it is largely effective at preventing postoperative complications due to CSF leakage, even in CI recipients who did not receive a FORM array.…”

Section: Discussionmentioning

confidence: 99%

“… 14 Indeed, this method continues to be used because it is largely effective at preventing postoperative complications due to CSF leakage, even in CI recipients who did not receive a FORM array. 5 , 7 , 13 , 14 However, to the best of our knowledge, Sennaroglu et al is the only study which assessed within one study the effectiveness of the cork-type array (the FORM's predecessor) and standard straight arrays in preventing postoperative CSF leak. They found that 20.7% (6/29) implanted with a straight array experienced postoperative rhinorrhea after a gusher; in contrast, only 4.2% (1/24) implanted with the cork-type array had either of these complications postoperatively.…”

Section: Discussionmentioning

confidence: 99%

FORM24 electrode array and perioperative cerebrospinal fluid leakage in cochlear implant recipients with cochleovestibular malformations

Halawani¹,

Alzhrani

Almuhawas

et al. 2020

Ann Saudi Med

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BACKGROUND: Cochlear implant (CI) recipients with a cochleovestibular malformation (CVM) are at a higher risk of experiencing an intra-operative cerebrospinal fluid (CSF) gusher and, therefore are at greater risk of developing postoperative meningitis than are CI recipients with normal cochlear anatomy. To control CSF gushers, the FORM electrode array was developed. OBJECTIVES: To assess the ability of the FORM24 electrode array in managing intraoperative CSF gushers and preventing postoperative CSF leakage in a population of CI recipients. DESIGN: Retrospective. SETTING: Tertiary health care center. PATIENTS AND METHODS: All CIs in which a FORM24 was used between January 2014 and March 2018 were reviewed for demographic and safety results. MAIN OUTCOME MEASURES: Safety results were assessed as the intraoperative or postoperative presence of an episode of CSF leakage or meningitis. SAMPLE SIZE: 177 CI recipients. RESULTS: Thirty-six (20.3%) had a CVM and 141 had normal anatomy (79.7%). Of the 36 participants with a CVM, 20 (55.6%) experienced an intraoperative CSF gusher, all of which were resolved. No cases of postoperative leakage or meningitis were recorded after a mean follow-up time of 36 months. CONCLUSION: The FORM24 array is able to help surgeons stop intraoperative CSF gushers and prevent postoperative CSF leakage and meningitis in CI recipients with a CVM. LIMITATIONS: Further studies are needed. CONFLICT OF INTEREST: None.

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“…Additionally, other studies reported a variable CI surgery outcome among patients based on types of inner ear anomalies [2,4,[23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Several authors reported that patients who have mild anomalies such as EVA and IP II have a better outcome than patients who have severe malformations such as a common cavity [4,[24][25][26][27][28]31]. Nevertheless, Tay et al has concluded that the outcome of patients who have an absent cochlear nerve, electrode folding and underlying neurological disorders is poor [37].…”

Section: Literature Reviewmentioning

confidence: 99%

The Effectiveness of Cochlear Implants in Patients with Inner Ear Malformation

Alefranji

2021

GJO

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To analyze the outcome of a cochlear implant (CI) in patients with an inner ear malformation (IEM), to compare two commonly used classification systems for IEM, to identify the highest and lowest outcome performance of IEM, to determine the most frequent inner ear anomalies and a candidate for a cochlear implant with considerable improvement.Methods: A literature review including 64 previously published studies between the period 1987 to 2020. In addition, a retrospective study inclusive 16 cases with IEM having undergone 20 CI surgeries. Results:The review shows that 43 studies involving 1273 (19%) cases with IEM out of 6560 patients have demonstrated an improvement in auditory and speech performance after implantation. 30 studies involving a total of 551 cases with an isolated enlarged vestibular aqueduct (EVA) have reported considerable benefits in audiology and speech performance after CI. Several authors reported that patients who have mild anomalies have a better outcome than patients who have severe malformations. Clinical studies revealed that patients with IEM have seen improvements in the outcome of audiology and speech tests after implantation. Conclusion:CI is effective for patients who have severe to profound sensorineural hearing loss (SNHL) with inner ear anomalies despite other factors which may influence the outcome. The outcome of the minor IEM such as EVA is higher than the performance of the major anomalies like a common cavity (CC). The most frequent inner ear anomaly and candidate for the CI with significant improvement after implantation is EVA.

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Cochlear Implantation in Children with Anomalous Cochleovestibular Anatomy: Our Experience

Cited by 15 publications

References 12 publications

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

FORM24 electrode array and perioperative cerebrospinal fluid leakage in cochlear implant recipients with cochleovestibular malformations

The Effectiveness of Cochlear Implants in Patients with Inner Ear Malformation

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