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Diagnostic yield of high-resolution computed tomography for pediatric sensorineural hearing loss
P J Antonelli1, A E Varela, A A Mancuso
1Department of Otolaryngology, University of Florida, Gainesville 32610-0264, USA. antonpj@ent.ufl.edu
Insights
High-resolution computed tomography (CT) effectively diagnoses subtle inner ear anomalies in children with sensorineural hearing loss (SNHL). This imaging provides valuable insights for patient counseling and management strategies.
Area of Science:
- Radiology
- Otolaryngology
- Pediatrics
Background:
- Subtle inner ear anomalies are increasingly detected with high-resolution computed tomography (CT).
- Sensorineural hearing loss (SNHL) in children necessitates accurate diagnosis of underlying causes.
Purpose of the Study:
- To evaluate the diagnostic utility of high-resolution CT in identifying inner ear abnormalities in pediatric patients with SNHL.
Main Methods:
- Retrospective review of temporal bone CT scans from children under 18.
- Analysis of 383 CT studies in 351 pediatric subjects over a 5-year period.
Main Results:
- High-resolution CT revealed significant inner ear findings in 31% of children with SNHL.
- Large vestibular aqueducts (15%) and cochlear dysplasias (11-12%) were common anomalies.
- Inner ear dysplasia incidence showed no significant difference between children with or without risk factors and did not correlate with hearing loss severity or type.
Conclusions:
- Radiographic imaging, specifically high-resolution CT, demonstrates a high diagnostic yield for pediatric SNHL.
- Identifying inner ear anomalies via CT can aid in patient counseling and inform management decisions for SNHL.
Objectives/Hypothesis:
In recent years, relatively subtle inner ear anomalies have become apparent using high-resolution computed tomography (CT). The purpose of this study was to determine the diagnostic yield of high-resolution CT for pediatric sensorineural hearing loss (HL) (SNHL).
Methods:
A review was performed on the records of all children (<18 y of age) who had undergone CT of the temporal bones over a 5-year period, since the introduction of current CT techniques.
Results:
Three hundred eighty-three studies were performed in 351 subjects. The indication for the CT was SNHL or mixed HL in 157 children. Forty-nine (31%) of these studies revealed significant inner ear findings. Large vestibular aqueducts (LVAs) were reported in 15%, commonly in association with cochlear modiolar deficiencies. Modiolar deficiencies (11%) and other cochlear dysplasias (12%) followed LVA in frequency. The incidence of inner ear dysplasia in children with perinatal or postnatal risk factors was only slightly lower than those without (22% vs. 32%, P > .05). The rate of dysplasias did not correlate with SNHL severity, pattern of HL, or type of HL (mixed vs. sensorineural).
Conclusions:
These findings suggest that radiographic imaging has a relatively high diagnostic yield in children with SNHL. These findings may be of value in counseling patients and guiding the management of their SNHL.