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Published on: January 9, 2019
Brain MRI findings of prelingually deaf children and cochlear implant outcome: Preliminary results
Majed Assiri1, Afrah Alshalan2, Rawan Alqahtani3
1King Abdullah Ear Specialist Center (KAESC), King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Insights
Brain abnormalities are found in over 10% of prelingually deaf children. These findings do not significantly impact hearing outcomes after cochlear implantation (CI), showing CI benefits for these patients.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Audiology
Background:
- Prelingually deaf children often undergo brain imaging before cochlear implantation (CI).
- Understanding the prevalence and impact of brain abnormalities in this population is crucial for surgical candidacy and outcome prediction.
Purpose of the Study:
- To determine the incidence of brain abnormalities in prelingually deaf children.
- To assess if these abnormalities affect hearing and speech outcomes post-CI.
Main Methods:
- Retrospective review of brain MRI scans from 285 prelingually deaf children under 12.
- Evaluation of auditory performance (CAP) and speech intelligibility (SIR) scores.
Main Results:
- 10.88% of children had abnormal findings, including brain abnormalities (54.8%) and inner ear anomalies (29%).
- White matter lesions were the most common brain abnormality; enlarged vestibular aqueduct was the most common inner ear anomaly.
- No significant difference in CAP and SIR scores between children with brain abnormalities versus inner ear anomalies.
Conclusions:
- Brain abnormalities are relatively common in prelingually deaf children evaluated for CI.
- These abnormalities do not significantly alter hearing and speech outcomes following CI.
- Prelingually deaf children with brain abnormalities can still achieve significant benefits from CI.
Objective:
To estimate the incidence of brain abnormalities in a cohort of prelingually deaf children and whether these abnormalities can impact the hearing outcomes of patients eligible for cochlear implantation (CI).
Methods:
We performed a retrospective review of consecutive medical charts of prelingually deaf children under 12 years of age who underwent brain magnetic resonance imaging (MRI) during their preoperative workup for CI surgery. We used the category of auditory performance (CAP) test and the speech intelligibility rating (SIR) test to assess the hearing and speech performance of the children, respectively.
Results:
The MRIs of 285 patients, 174 boys and 111 girls with a mean age of 36.4 (±16) months, were evaluated for this study. We identified 31 patients with abnormal findings (10.88%): (17/31) (54.8%) had MRI brain abnormalities, (9/31) (29%) had inner ear anomalies, and (5/31) (16.1%) had both inner ear and brain abnormalities. The most frequent inner ear anomaly was an enlarged vestibular aqueduct, while white matter lesions were the most common brain abnormality. The CAP and SIR mean score of patients with inner ear anomalies was slightly, but not significantly, higher than those of patients with brain abnormalities.
Conclusion:
CAP and SIR scores were not significantly different in children with brain abnormalities than inner ear anomalies. These patients can still benefit from CI to improve their overall hearing and speech performance.
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