title: Utility of preoperative computed tomography and magnetic resonance imaging in adult and pediatric cochlear implant candidates.
abstract: Determine the utility of preoperative imaging in adult and pediatric cochlear implant candidates.
  
  
  
  Retrospective chart review.
  
  
  
  Medical records of 101 consecutive adult and 20 consecutive pediatric patients who underwent 137 cochlear implantation (CI) procedures at a single institution were reviewed.
  
  
  
  Computed tomography (CT) was obtained preoperatively in 110 (90.9%) patients, preoperative magnetic resonance imaging (MRI) was obtained in 102 (84.3%) patients, and both were obtained in 94 (77.7%) patients. MRI revealed one acoustic neuroma and two meningiomas, which affected surgical planning for three (2.2%) procedures. MRI identified enlarged vestibular aqueduct (EVA) in 2.0% of adult patients. CT demonstrated middle ear disease in four (3.3%) patients. CT was useful in indicating round window and cochlear patency in three (2.2%) patients with cochlear otosclerosis. Twenty pediatric patients underwent 27 CI procedures. Preoperative CT in the pediatric cohort demonstrated five (25%) dysplastic cochleae, three (15%) dysplastic vestibules and/or semicircular canals, and three (15%) EVAs. In one patient, CT demonstrated a duplicated right internal auditory canal (IAC) and hypoplastic left IAC; MRI confirmed hypoplastic cochlear nerves.
  
  
  
  Preoperative MRI can demonstrate retrocochlear pathology, cochlear patency, and EVA in adults being evaluated for cochlear implantation. CT may provide additional information in patients with chronic otitis media or otosclerosis. However, in postlingually deafened adults without conductive or asymmetrical hearing loss, imaging is unlikely to affect surgical decision making. Both CT and MRI can identify anomalies in pediatric patients. MRI does not offer substantial benefit over CT for routine evaluation of pediatric inner ear and temporal bone anatomy.
  
  
  
  4 Laryngoscope, 126:1440-1445, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California.
authors.forename: Matthew
authors.initials: M
authors.lastname: Tamplen
authors.affiliation: University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Adam
authors.initials: A
authors.lastname: Schwalje
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Columbia University, College of Physicians & Surgeons, New York, New York.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lustig
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California.
authors.forename: Aurash S
authors.initials: AS
authors.lastname: Alemi
authors.affiliation: House Clinic, Los Angeles, California, U.S.A.
authors.forename: Mia E
authors.initials: ME
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000000981:diagnostic imaging / Q000601:surgery; D019929:Cochlear Implantation / Q000379:methods*; D003638:Deafness / Q000000981:diagnostic imaging* / Q000601:surgery; D007758:Ear, Inner / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014723:Vestibular Aqueduct / Q000002:abnormalities / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Cochlear implant; otology; pediatric otology; radiology