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Updated: Oct 15, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Evaluation of the Prognostic Capacity of the Imaging Features in Cochlear Implant Patients with Cochlear Nerve
Zhencheng Gao1, Simeng Lu1, Xingmei Wei1
1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China.
Background:
Cochlear nerve deficiency (CND) is a prevalent inner ear malformation, and several studies have identified a correlation between imaging features and postoperative outcomes in cochlear implant patients with CND. Nevertheless, the extent to which various imaging features influence postoperative cochlear implantation (CI) outcomes remains unclear. This study sought to identify the imaging parameter with the most significant impact on postoperative outcomes in CND patients.
Methods:
A total of 107 CND children were included in this study. Imaging features, including internal auditory canal (IAC) diameter, IAC nerve grade, vestibulocochlear nerve (VCN) area, and the area ratio of the vestibulocochlear nerve to the facial nerve (VCN/FN), were evaluated. The optimal cut-off values for each continuous imaging parameter were calculated via maximally selected rank statistics. The effects of imaging features and clinical data on the postoperative auditory and speech outcomes of CND children were analyzed.
Results:
Univariate Cox regression identified higher IAC nerve grade (Grade IV), IAC diameter, VCN area, and VCN/FN ratio as predictors of better auditory performance after CI. Female sex, higher IAC nerve grade, IAC diameter, VCN area, and VCN/FN ratio were associated with better speech performance. Multivariate analysis showed that higher IAC nerve grade and VCN/FN ratio independently predicted auditory performance, whereas only the VCN/FN ratio independently predicted speech performance.
Conclusion:
A higher VCN/FN ratio is the most robust imaging predictor of postoperative outcomes in CND children, independently predicting both auditory and speech performance after CI.
