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Computed tomography and/or magnetic resonance imaging before pediatric cochlear implantation? Developing an investigative strategy.
- Source :
-
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2007 Apr; Vol. 28 (3), pp. 317-24. - Publication Year :
- 2007
-
Abstract
- Objective: To investigate and compare the usefulness of preoperative magnetic resonance (MR) imaging and high-resolution temporal bone computed tomography (HRCT) in pediatric cochlear implant candidates.<br />Study Design: Prospective.<br />Setting: Tertiary referral center.<br />Patients: A cohort of 92 pediatric patients with profound hearing. Inclusion criteria were MR, computed tomography, and cochlear implantation. INTERVENTION.<br />Diagnostic: All patients had preoperative imaging of the petrous temporal bone (HRCT, T2-weighted fast spin echo, axial 3D Fast Imaging Employing Steady-state Acquisition [FIESTA] MR) and brain (Fast Fluid-attenuated Inversion-recovery [FLAIR] MR).<br />Main Outcome Measure(s): Overall prevalence of inner ear dysplasias in this population and comparison of detection rates between HRCT, T2 Fast Spin Echo (FSE), and FIESTA MR sequences.<br />Results: Radiological abnormalities were observed in 32 and 59% of MR and HRCT temporal bone, respectively. Synchronous intracranial findings were noted in 40% on brain MR. Common vestibulocochlear nerve was observed in 3% ears and directed side of implantation. Consistent discrepancies noted on HRCT were inability to diagnose early obliterative labyrinthitis and presence of the cochlear nerve in the internal auditory canal. With respect to MR, enlarged vestibular aqueducts and narrow cochlear nerve canals were consistently under identified.<br />Conclusion: Dual-modality imaging with HRCT and MR of petrous bone and MR brain in the precochlear implant pediatric population detects abnormalities related to deafness, which would not otherwise be found using either modality alone. There is overlap between the imaging modalities in the type of abnormalities detected, and we present a case for selective use of HRCT within a diagnostic algorithm, using the patient risk factors we have identified.
- Subjects :
- Adolescent
Bone Diseases, Developmental diagnostic imaging
Bone Diseases, Developmental epidemiology
Bone Diseases, Developmental pathology
Child
Child, Preschool
Cochlear Nerve pathology
Cochlear Nerve physiopathology
Diagnosis, Differential
Female
Hearing Loss, Sensorineural diagnosis
Hearing Loss, Sensorineural physiopathology
Humans
Labyrinthitis diagnosis
Labyrinthitis physiopathology
Male
Petrous Bone diagnostic imaging
Petrous Bone pathology
Prevalence
Prospective Studies
Radiography, Dual-Energy Scanned Projection
Temporal Bone diagnostic imaging
Temporal Bone pathology
Vestibular Aqueduct physiopathology
Cochlear Implantation
Health Planning
Hearing Loss, Sensorineural surgery
Magnetic Resonance Imaging
Preoperative Care
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1531-7129
- Volume :
- 28
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
- Publication Type :
- Academic Journal
- Accession number :
- 17414036
- Full Text :
- https://doi.org/10.1097/01.mao.0000253285.40995.91