Evaluation by imaging methods of cochlear implant candidates: radiological and surgical correlation

Júnior, Luiz Rodolpho Pena Lima; Rocha, Marina David; Walsh, Priscilla Vargas; Antunes, Camila André; Calhau, Clara Maria Dias Ferreira

doi:10.1016/s1808-8694(15)30574-7

Cited by 11 publications

(14 citation statements)

References 10 publications

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“…This study demonstrated that CT and MRI were superior to CT alone. 5 A similar experience was observed in our study, where CT and MRI were found superior in decision making Role of High-Resolution Imaging in Cochlear Implant Surgery Tiwari et al…”

Section: Discussionsupporting

confidence: 86%

Role of High-Resolution CT and MRI in Predicting the Degree of Difficulty in Patients undergoing Cochlear Implant Surgery: An Institutional Experience

Tiwari

Kumar

Mishra

et al. 2020

Annals of Otology and Neurotology

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Introduction Preoperative imaging is a standard practice for cochlear implant candidacy. We are discussing association between surgical feasibility and various anatomical details of middle and inner ear by both high-resolution computed tomography (HRCT) and 3T magnetic resonance imaging (MRI) in patients with bilateral sensorineural hearing loss (SNHL) and are used as a guide during surgery as well as foresee complications in cochlear implantation. Materials and Methods A total of 56 patients of aged 1 to 5 years (prelingual) and > 1 years (postlingual or perilingual) having bilateral SNHL were included in the study. HRCT temporal bone and MRI head was done in all candidates. Based on the imaging findings of CT and MRI, patients were divided into two categories (normal and abnormal). Demographic and clinical values were compared between two groups. Binary logistic regression analysis was used to identify the predictors of the outcome variable (surgical difficulty). Results Out of 56 patients, 55 underwent cochlear implantation by Veria technique, one patient having Michel’s deformity was denied surgery and was advised brain stem implant. Note that 69.1% patients had no radiological abnormality, while 30.9% patients showed abnormality including acquired disease and malformation. Out of the total study patients, 18% (n = 10) showed various type of congenital inner ear malformation. Large size of the external auditory canal (EAC), high basal turn angle (BTA), and increased distance between tympanic segment of facial canal to EAC (midpoint between level of I-S joint corresponding to EAC and exit of chordae tympanic at level of EAC), all these factors showed inverse relationship with difficulty in surgery, which were found to be statistically significant. Conclusion The imaging in cochlear implant patients is an essential tool for preoperative assessment of candidacy, surgical planning, and avoid intra- and postoperative complications. BTA and distance between tympanic segment of facial nerve and EAC (midpoint between level of I-S joint corresponding to EAC and exit of chordae tympanic at level of EAC) are important predictors for evaluating intra- and postoperative complications.

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Section: Discussionsupporting

confidence: 86%

Role of High-Resolution CT and MRI in Predicting the Degree of Difficulty in Patients undergoing Cochlear Implant Surgery: An Institutional Experience

Tiwari

Kumar

Mishra

et al. 2020

Annals of Otology and Neurotology

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“…We performed CT and NMR in all the 9 patients and observed enlargement of the vestibular aqueduct in 1 patient and incudomalleolar malformation in another. These imaging findings were not thought to be of relevance for contra-indication of surgery 3 . However, they are important in order that the surgeon has notion of the potential intra-operating problems that can take place.…”

Section: Discussionmentioning

confidence: 90%

“…The patient candidates for the IC undergo an evaluation surgical-daily pay. In this evaluation, the imaging examinations including CT and NMR are carried out with the realization that they are of basic importance while making possible the identification of findings that would counter-indicate the surgery, assiting in the choice of the ear being introduced, assessing appropriately the anatomy of the area to be explored during the surgery and, inside their limitations, allowing a previsualization of areas of potential complications 3 . The conjugated use of the CT and NMR of the result in better agreement of the obtained information and help the surgeon intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

Cochlear implants: our experience and literature review

Martins¹,

Lima

Júnior

et al. 2012

Int Arch Otorhinolaryngol

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Summary Introduction: Cochlear Implants are important for individuals with severe to profound bilateral sensorineural hearing loss. Objective: Evaluate the experience of cochlear implant center of Otorhinolaryngology through the analysis of records of 9 patients who underwent cochlear implant surgery. Methods: This is a retrospective study performed with the patients records. Number 0191.0.107.000-11 ethics committee approval. We evaluated gender, etiology, age at surgery, duration of deafness, classification of deafness, unilateral or bilateral surgery, intraoperative and postoperative neural response and impedance of the electrodes in intraoperative and preoperative tests and found those that counter-indicated surgery. Results: There were 6 pediatric and 3 adult patients. Four male and 5 female. Etiologies: maternal rubella, cytomegalovirus, ototoxicity, meningitis, and sudden deafness. The age at surgery and duration of deafness ranged from 2–46 years and 2–18 years, respectively. Seven patients were pre-lingual. All had profound bilateral PA. There were 7 bilateral implants. Intraoperative complications: hemorrhage. Complications after surgery: vertigo and internal device failure. In 7 patients the electrodes were implanted through. Telemetry showed satisfactory neural response and impedance. CT and MRI was performed in all patients. We found enlargement of the vestibular aqueduct in a patient and incudomalleolar malformation. Conclusion: The cochlear implant as a form of auditory rehabilitation is well established and spreading to different centers specialized in otoaudiology. Thus, the need for structured services and trained professionals in this type of procedure is clear.

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“…who found that the sensitivity of CT was 36.36% and the specificity was 86.36%. [ 25 ] This can be explained by the fact that in imaging the jugular bulb is considered high if it reaches the level of the basal turn of cochlea regardless of whether it is hiding round window niche; however, surgeons are dealing only with the high bulb that may interfere with the accessibility of round window.…”

Section: Discussionmentioning

confidence: 99%

Radiological requirements for surgical planning in cochlear implant candidates

Alam-Eldeen

Rashad

2017

Indian Journal of Radiology and Imaging

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Objective:This study is concerned with clarification of radiological findings that should be addressed and reported in patients listed for cochlear implant (CI) operation. These findings may force a surgeon to consider modifications of the surgical approach by a CI surgeon.Materials and Methods:The study was performed from January 2015 to January 2016. It included 50 patients with severe-to-profound sensorineural hearing loss who fulfilled the criteria for CI. Patients underwent CI surgery in the Department of Otolaryngology. All patients underwent preoperative computed tomography (CT) and magnetic resonance imaging (MRI) assessment in the Department of Diagnostic Radiology. Combined examination of the CT and MRI by the radiologist and the surgeon was advocated.Results:Many anatomical variants were observed regarding the pattern of mastoid pneumatization, position of middle cranial fossa dura, sigmoid sinus position jugular bulb position, and the size and position of the mastoid segment of facial nerve canal. Labyrinthitis ossificans was seen in 3 patients (6%), otospongiosis in 1 patient (2%), and dilated vestibular aqueduct and endolymphatic sac in 9 patients (18%).Conclusion:Cochlear implantation is a major treatment modality in patients with severe-to-profound sensorineural hearing loss. Radiological evaluation is integral in surgery planning.

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Evaluation by imaging methods of cochlear implant candidates: radiological and surgical correlation

Abstract: The preoperative radiological evaluation by CI was effective in identifying anatomic abnormalities, allowing surgeons to avoid, or at least be aware of, possible complications. This study demonstrated that CT and MRI were superior to CT alone.

Cited by 11 publications

References 10 publications

Role of High-Resolution CT and MRI in Predicting the Degree of Difficulty in Patients undergoing Cochlear Implant Surgery: An Institutional Experience

Role of High-Resolution CT and MRI in Predicting the Degree of Difficulty in Patients undergoing Cochlear Implant Surgery: An Institutional Experience

Cochlear implants: our experience and literature review

Radiological requirements for surgical planning in cochlear implant candidates

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