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The narrow internal auditory canal in children: a contraindication to cochlear implants
C Shelton1, W M Luxford, L L Tonokawa
1Otologic Medical Group, Inc., Los Angeles, CA 90057.
Summary
A narrow internal auditory canal and absent cochlear nerve may explain why some children with cochlear implants do not hear. This finding on imaging is a contraindication for cochlear implantation.
Area of Science:
- Otolaryngology
- Neuroscience
- Medical Imaging
Background:
- Cochlear implants aim to restore hearing in deaf individuals.
- Auditory response to cochlear implantation varies among pediatric patients.
- The underlying cause for non-response in some cases remains unclear.
Observation:
- A narrow internal auditory canal (1-2 mm diameter) was observed.
- Probable absence or aplasia of the cochlear nerve was noted.
- This anomaly was identified using high-resolution computed tomographic (CT) x-ray studies.
Findings:
- Eight children presented with this auditory-vestibular nerve aplasia.
- Three children received cochlear implants but experienced no auditory sensation.
- The identified defect is a contraindication for cochlear implantation.
Implications:
- This provides a new explanation for failed cochlear implant outcomes in specific pediatric cases.
- Pre-operative imaging is crucial for identifying this contraindication.
- Screening CT scans can prevent unnecessary cochlear implant surgeries for auditory stimulation.