Role of modern imaging technology in the implementation of pediatric cochlear implants.
Since 1989, 40 patients have received cochlear implants in our institution. Over the past 2 years, 17 children among these patients have undergone radiographic assessment combining magnetic resonance imaging (MRI) and high-resolution computed tomography (CT) scanning. Imaging is not essential, and is only used after assessment by a multidisciplinary team. However, the imaging results influence the choice of implant, and sometimes the side to be implanted. The first study is always CT, as it detects congenital abnormalities, and for children with a history of bacterial meningitis, it can detect signs of labyrinthine ossification that contraindicates or complicates cochlear implantation. These signs are not always visible with tomodensitometry, especially when fibrosis within the canal has not yet ossified. This examination also provides for postoperative confirmation of implant position in case of failure or complication. Over the past 3 years, MRI has been combined with tomodensitometry, especially with children having a history of meningitis. This examination provides a basis for evaluating the liquid nature of the labyrinth. A GE Signa 1.5-T unit was used by the authors, employing sequences of volumetric acquisition (steady state free precision with 1.5-mm image slices and an angle of 15 degrees to 35 degrees). Hence, modern imaging plays an important role when the decision to implant has already been made, particularly in the case of profoundly deaf children. We always use MRI in combination with a CT scanner in children with a history of meningitis.
Department of Pediatric Radiology, Trousseau Children's Hospital, Paris, France.
B
B
Silberman
E N
EN
Garabedian
F
F
Denoyelle
L
L
Moatti
G
G
Roger
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003054:Cochlear Implants; D005355:Fibrosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009999:Ossification, Heterotopic / Q000175:diagnosis; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis; D011300:Preoperative Care; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed