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Updated: Feb 7, 2026

Sound Source Localization Testing in Single-sided Deafness Following Bone Conduction Intervention
Published on: December 20, 2024
Extremely common radiographic finding of cochlear nerve deficiency among infants with prelingual single-sided
Woongsang Sunwoo1, Won-Wook Lee2, Byung Yoon Choi2
1Department of Otorhinolaryngology-Head & Neck Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Insights
Cochlear nerve deficiency (CND) was present in 100% of infants with prelingual single-sided deafness (SSD). This finding, identified via internal auditory canal MRI, highlights CND
Area of Science:
- Otolaryngology
- Pediatric Radiology
- Neuroscience
Background:
- Prelingual single-sided deafness (SSD) in infants presents diagnostic challenges.
- Understanding the underlying causes, such as cochlear nerve deficiency (CND), is crucial for management.
- Newborn hearing screening programs identify infants with SSD, necessitating further investigation.
Purpose of the Study:
- To describe radiographic findings in prelingual SSD.
- To determine the prevalence of CND in infants diagnosed with SSD via newborn hearing screening.
- To correlate CND with internal auditory canal (IAC) and cochlear nerve canal (CNC) dimensions.
Main Methods:
- Retrospective review of infants with prelingual SSD (under 1 year) from March 2012 to March 2017.
- Inclusion of 24 well infants without risk factors undergoing IAC magnetic resonance imaging (MRI).
- Measurement of cochlear nerve (CN), IAC, and CNC sizes on MRI; CND defined as absent or smaller CN compared to facial nerve.
Main Results:
- Cochlear nerve deficiency (CND) was identified in all 24 infants (100%) with SSD.
- Absent CN occurred in 83.3% (20/24), and small CN in 16.7% (4/24).
- Absent CN was associated with a higher prevalence of narrow IAC (85%) and narrow CNC (85%).
Conclusions:
- Cochlear nerve deficiency (CND) is a universal finding in Korean infants with prelingual SSD.
- IAC MRI alone is sufficient to diagnose CND in this population.
- The high prevalence of CND and associated narrow IAC/CNC warrants further investigation into their etiology and impact.
Objectives:
To clarify the common radiographic findings of audiologically documented prelingual single-sided deafness (SSD) and identify the prevalence of cochlear nerve deficiency (CND) in SSD infants referred from the newborn hearing screening program.
Methods:
Between March 2012 and March 2017, the records of all infants referred to our otology clinic after undergoing newborn hearing screening program were retrospectively reviewed. Twenty-four consecutive well infants without risk factors who had a confirmed diagnosis of prelingual SSD under the age of 1 year and who underwent internal auditory canal (IAC) magnetic resonance imaging (MRI) were included. The sizes of cochlear nerve (CN), IAC, and cochlear nerve canal (CNC) were measured on MRI. The presence of CND was visually determined by comparing the CN size to the ipsilateral facial nerve (FN) in the affected side via an oblique sagittal view of IAC MRI and defined when CN was absent or smaller than FN.
Results:
CND was seen in all 24 deaf ears (100%) on MRI. There was one with incomplete partition type I, and another with combined cochleovestibular nerve absence. Twenty-four subjects demonstrated either an absent (20/24, 83.3%) or small (4/24, 16.7%) CN. When the absent and small CN groups were compared, the former group had a higher prevalence of narrow CNC and narrow IAC. Of the 20 infants without identifiable CN on the affected side, 17 (85%) had narrow IAC and 17 (85%) had narrow CNC. In the 20 ears with absent CN, only one had both normal-sized IAC and CNC.
Conclusion:
The contribution of CND to prelingual SSD in Korean infants reached 100%, according to IAC MRI alone.
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