Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

Palabıyık, Figen; Hacıkurt, Kadir; Yazıcı, Zeynep

doi:10.1017/s0022215116009555

Cited by 12 publications

(7 citation statements)

References 18 publications

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“…In the current study, syndromes with known association with anomalous courses of the facial nerve (i.e., CHARGE syndrome, aural atresia) received up‐front HRCT, as an abnormal course of the facial nerve can create a tight and difficult access to the round window and, correspondingly, a challenging electrode implantation with increased risk of injury . At least four large reports have demonstrated an association between inner ear malformation and facial nerve anomaly, with a range of 0.3% to 23% facial nerve abnormality coexisting with an inner ear abnormality . Importantly, in each of these studies, no facial nerve anomalies were detected in children with normal inner ear structures.…”

Section: Discussionmentioning

confidence: 97%

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: 97%

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

et al. 2019

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“…Much has been written about displacement of the intracranial portion of the facial nerve as it pertains to neurotologic surgery, but little to nothing has been reported about aberrancy of the nerve in parotid surgery. Extensive review of the literature revealed several studies that have discussed the indications and surgical approach to deep lobe parotid lesions; however, there was no discourse regarding abnormal facial nerve position due to deep lobe lesions.…”

Section: Introductionmentioning

confidence: 99%

Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Maddalozzo

Johnston

Isaac

et al. 2019

Laryngoscope Investig Oto

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Objectives To describe and investigate facial nerve displacement in deep lobe parotid lesions in children and to determine clinical and radiographic predictors of abnormal facial nerve position. Methods Retrospective case review of children who underwent total parotidectomy for deep lobe parotid lesions at a tertiary care center between January 2014 and December 2017. Aberrant facial nerve trajectory was defined as ascension of the nerve at an angle of 45° or greater. Elongation was defined as the main trunk >2 cm in length. Patient demographics, radiographic, pathologic results, postoperative nerve weakness, and intraoperative nerve findings were collected. Wilcoxon rank‐sum test and Fisher's exact test were used to assess the associations between variables of interest and facial nerve position. Results A total of 20 patients were included. The mean age was 7.7 ± 5 years. The most common pathologies were lymphatic malformation, pleomorphic adenoma, and first branchial cleft cyst. Twelve out of twenty (60.0%) patients had abnormal intraoperative facial nerve position. There was no significant difference in distribution of pathologies between those with or without an abnormal intraoperative nerve position (P = .41). Neither radiographic lesion size nor distance between the lesion and proximal portion of the facial nerve (mastoid tip) were associated with abnormal facial nerve position intraoperatively. Conclusion Pediatric deep lobe parotid lesions can displace the facial nerve and distort its anatomy in a posterior lateral direction, in approximately 60% of patients. Statistical analysis of increased numbers of patients to further define predictors of aberrant nerve course is warranted. Level of Evidence 4.

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“…Malformations of the inner ear are frequently accompanied by abnormal positions of the facial nerve, which increases the risk of facial nerve palsy during surgery [ 34 ]. The labyrinthine segment of the facial nerve may show an anterior and superior displacement.…”

Section: Pre-operative Imagingmentioning

confidence: 99%

Pre- and post-operative imaging of cochlear implants: a pictorial review

et al. 2020

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Cochlear implants are increasingly used to treat sensorineural hearing disorders in both children and adults. Pre-operative computed tomography and magnetic resonance imaging play a pivotal role in patient selection, to rule out findings that preclude surgery or identify conditions which may have an impact on the surgical procedure. The post-operative position of the electrode array within the cochlea can be reliably identified using cone-beam computed tomography. Recognition of scalar dislocation, cochlear dislocation, electrode fold, and malposition of the electrode array may have important consequences for the patient such as revision surgery or adapted fitting.

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Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

Cited by 12 publications

References 18 publications

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation

Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Pre- and post-operative imaging of cochlear implants: a pictorial review

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