Cochlear clefts in children: prevalence, characteristics, and clinical implications

Area of Science:

• Radiology
• Pediatric Imaging
• Otolaryngology

Background:

• Temporal bone computed tomography (CT) is vital for diagnosing ear diseases.
• Cochlear clefts, indicated by pericochlear CT hypoattenuation, represent incomplete endochondral ossification, primarily in children.
• This normal variant can be mistaken for conditions like otosclerosis, necessitating further research into its prevalence and significance.

Purpose of the Study:

• To determine the prevalence of cochlear clefts in pediatric temporal bone CT scans.
• To assess the clinical significance and potential impact of cochlear clefts on diagnosis.

Main Methods:

• Retrospective review of 404 pediatric temporal bone CT scans.
• Two neuroradiologists assessed prevalence and extent of pericochlear CT hypoattenuation (cochlear clefts).
• Correlation analysis between cochlear clefts and clinical findings, including age and hearing status.

Main Results:

• Cochlear clefts were identified in 135 out of 404 scans (33.4%).
• The presence of cochlear clefts was significantly associated with younger age (0-4 years, P<0.001).
• No association was found with sex, hearing loss, inner ear anomalies, or other temporal bone pathologies.

Conclusions:

• Cochlear clefts are a common anatomical variation in young children, linked to age.
• Pericochlear CT hypoattenuation in children requires careful interpretation to differentiate from pathology.
• Radiologist awareness of cochlear clefts is essential to avoid misdiagnosis and unnecessary interventions.