Adult progressive sensorineural hearing loss: is preoperative imaging necessary before cochlear implantation?
OBJECTIVE
Preoperative evaluation of cochlear implant candidate includes routine imaging to identify anatomic abnormalities that may preclude or complicate implantation, such as cochlear aplasia, absent/narrowed internal auditory canals, cochlear ossificans, or significant traumatic fracture. The aim of this study is to determine if preoperative imaging is necessary in select cochlear implant candidates, thus defraying cost and ionizing radiation.


METHODS
Retrospective chart review.


METHODS
Tertiary referral facility.


METHODS
Adult patients with progressive sensorineural hearing loss without evidence of head trauma, meningitis, or congenital hearing loss who underwent cochlear implantation.


METHODS
Diagnostic and therapeutic.


METHODS
Preoperative radiologic abnormalities, deviation from standard cochlear implant operation.


RESULTS
One hundred eighteen cochlear implants met inclusion criteria; 23.7% of CT scans had a documented abnormality, including chronic otitis media (14.4%), otosclerosis (4.2%), and an enlarged vestibular aqueduct (3.4%). There were 6 eventful surgeries in patients with normal documented CT scan. Events included multiple insertion attempts (3.4%), CSF leak (2.5%), and no apparent round window (2.5%). In every case, a cochlear implant was able to be placed successfully.


CONCLUSIONS
In the appropriately selected patient, preoperative imaging is not necessary as it does not impact the cochlear implant surgery and will defray cost and ionizing radiation.
Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, U.S.A.
Deanne M
DM
Roberts
Matthew L
ML
Bush
Raleigh O
RO
Jones
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003051:Cochlea / Q000000981:diagnostic imaging* / Q000601:surgery; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D007758:Ear, Inner / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011859:Radiography; D055815:Young Adult