Yigit Ozgur, Kalaycik Ertugay Cigdem, Yasak Ahmet Gorkem, Araz Server Ela
Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey.
Kulak Burun Boğaz Kliniği, İstanbul Eğitim ve Araştırma Hastanesi, Kasap İlyas Mah., Org. Abdurrahman Nafiz Gürman Cad., Fatih, 34098, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2019 May;276(5):1307-1311. doi: 10.1007/s00405-019-05349-0. Epub 2019 Feb 25.
There is no guideline or consensus on preoperative radiologic imaging modality despite the fact that it has a vital importance in appropriate candidacy selection of cochlear implantation. We aimed to find out the role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) on surgical planning, intraoperative technique in cochlear implant candidates.
The clinical charts, imagings, and operative reports of patients who underwent cochlear implant surgery at a tertiary institution were retrospectively examined.
611 patients (503 children and 108 adult) were enrolled into the study. We found 11 different pathologies in MRI which could not be seen in HRCT. However, we decided the side of surgery according to MRI in only three of them in which the pathology was cochlear nerve hypoplasia. Two patients with cochlear nerve hypoplasia were children with prelingual deafness and one was adult with perilingual deafness. Moreover, we changed the surgical planning of side according to both imaging modalities in nine patients. Seven of them were children and two were adult. One of these adults had cochlear anomaly, and another had bilateral temporal bone fracture.
We suggest both imaging modalities in pediatric candidates. However, in adults, we think that superiority of either imaging modalities is still contradictive. We had only three adult patients and the decision of the side of surgery was made according to MRI in one of them and to both imaging modalities in the other two adults.
尽管术前放射影像学检查对于人工耳蜗植入合适候选者的选择至关重要,但目前尚无相关指南或共识。我们旨在探讨高分辨率计算机断层扫描(HRCT)和磁共振成像(MRI)在人工耳蜗植入候选者手术规划及术中技术方面的作用。
回顾性分析一家三级医疗机构中接受人工耳蜗植入手术患者的临床病历、影像学检查及手术报告。
611例患者(503例儿童和108例成人)纳入本研究。我们在MRI中发现了11种HRCT未显示的不同病变。然而,仅在其中3例病变为蜗神经发育不全的患者中,我们根据MRI确定了手术侧别。2例蜗神经发育不全患者为语前聋儿童,1例为语后聋成人。此外,9例患者根据两种影像学检查结果改变了手术侧别的规划。其中7例为儿童,2例为成人。这些成人患者中,1例有耳蜗异常,另1例有双侧颞骨骨折。
我们建议对儿童候选者同时采用两种影像学检查。然而,对于成人患者,我们认为两种影像学检查的优势仍存在争议。我们仅有3例成年患者,其中1例根据MRI确定手术侧别,另外2例根据两种影像学检查结果确定手术侧别。