Document Detail


Computed tomography and/or magnetic resonance imaging before pediatric cochlear implantation? Developing an investigative strategy.
MedLine Citation:
PMID:  17414036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. STUDY DESIGN: Prospective. SETTING: Tertiary referral center. PATIENTS: A cohort of 92 pediatric patients with profound hearing. Inclusion criteria were MR, computed tomography, and cochlear implantation. INTERVENTION. 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). 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. 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. 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.
Authors:
Keith Trimble; Susan Blaser; Adrian L James; Blake C Papsin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  28     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-06-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-24     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, Toronto, Canada. keith.trimble@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Bone Diseases, Developmental / epidemiology,  pathology,  radiography
Child
Child, Preschool
Cochlear Implantation*
Cochlear Nerve / pathology,  physiopathology
Diagnosis, Differential
Female
Health Planning*
Hearing Loss, Sensorineural / diagnosis,  physiopathology,  surgery*
Humans
Labyrinthitis / diagnosis,  physiopathology
Magnetic Resonance Imaging*
Male
Petrous Bone / pathology,  radiography
Preoperative Care*
Prevalence
Prospective Studies
Radiography, Dual-Energy Scanned Projection
Temporal Bone / pathology,  radiography
Tomography, X-Ray Computed*
Vestibular Aqueduct / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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