Which imaging modality in cochlear implant candidates?

Area of Science:

• Otolaryngology
• Medical Imaging
• Neurosurgery

Background:

• Preoperative radiologic imaging is vital for cochlear implantation candidacy selection.
• No established guidelines or consensus exist for optimal imaging modality choice.

Purpose of the Study:

• To evaluate the roles of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in surgical planning and intraoperative technique for cochlear implant candidates.
• To determine the added value of MRI over HRCT in identifying pathologies relevant to cochlear implantation.

Main Methods:

• Retrospective examination of clinical charts, imaging, and operative reports from patients undergoing cochlear implant surgery.
• Analysis of 611 patients (503 children, 108 adults) to compare findings from HRCT and MRI.

Main Results:

• MRI identified 11 pathologies not visible on HRCT.
• Cochlear nerve hypoplasia, identified by MRI, influenced surgical side selection in three patients (two children, one adult).
• Surgical planning was altered based on both modalities in nine patients (seven children, two adults), including cases of cochlear anomaly and temporal bone fracture.

Conclusions:

• Both HRCT and MRI are recommended for pediatric cochlear implant candidates.
• The superiority of HRCT or MRI in adult candidates remains inconclusive due to limited adult data.
• Further research is needed to establish definitive guidelines for adult imaging in cochlear implantation.