Department of Pediatric Otolaryngology, Rady Children's Hospital San Diego, San Diego, CA, USA.
Department of Otolaryngology-Head & Neck Surgery, Naval Medical Center San Diego, San Diego, CA, USA.
Cochlear Implants Int. 2021 Mar;22(2):96-102. doi: 10.1080/14670100.2020.1830239. Epub 2020 Oct 11.
The goal of the study is to investigate the association of pertinent preoperative temporal bone computed tomography (CT) and brain magnetic resonance imaging (MRI) results and intraoperative surgical findings and complications of pediatric cochlear implantation reported in academic settings.
This is a retrospective review of cochlear implant patients who received a pre-operative temporal bone CT and MRI of the brain between 2005 and 2012 at academic pediatric otolaryngology practices within children's hospitals in the United States and France. Scans were reviewed in a double-blind fashion and compared to intraoperative findings.
91 children were analyzed (mean age 5.54 +/- 0.58 years). A small facial recess identified on CT was associated with difficult insertion of electrodes (= 0.0003). A prominent sigmoid sinus noted on CT was associated of difficult insertion of electrodes (= 0.01), iatrogenic tegmen dehiscence (= 0.005), as well as difficult round window access (= 0.025). No specific CT finding was found to be associated with external auditory canal injury, perilymphatic gusher, or iatrogenic facial nerve injury. MRI brain and internal auditory canal findings were not predictive of surgical outcomes.
Preoperative CT and MRI remain an important planning tool for pediatric cochlear implantation, particularly in academic institutions. The findings of our study demonstrate that a detailed assessment of both preoperative CT and MRI are valuable for teaching and surgical planning.
本研究旨在探讨相关的术前颞骨计算机断层扫描（CT）和脑磁共振成像（MRI）结果与术中手术发现和并发症之间的关联，这些并发症在学术环境中报告了儿科耳蜗植入。
这是一项对接受术前颞骨 CT 和脑 MRI 的耳蜗植入患者的回顾性研究，这些患者于 2005 年至 2012 年在美国和法国的儿童医院的学术儿科耳鼻喉科实践中接受了治疗。扫描以双盲方式进行审查，并与术中发现进行比较。
分析了 91 名儿童（平均年龄 5.54 ± 0.58 岁）。CT 上发现的小面神经隐窝与电极插入困难有关（= 0.0003）。CT 上发现的明显乙状窦与电极插入困难（= 0.01）、医源性鼓室盖缺损（= 0.005）以及圆窗难以进入（= 0.025）有关。没有发现特定的 CT 发现与外耳道损伤、外淋巴漏或医源性面神经损伤有关。MRI 脑和内听道发现与手术结果无关。
术前 CT 和 MRI 仍然是儿科耳蜗植入的重要规划工具，特别是在学术机构中。我们的研究结果表明，详细评估术前 CT 和 MRI 对于教学和手术规划都非常有价值。
