Cochlear Implantation in Children With Cochlear Nerve Absence or Deficiency

Kutz, Joe Walter; Lee, Kenneth H.; Isaacson, Brandon; Booth, Timothy N.; Sweeney, Melissa; Roland, Peter S.

doi:10.1097/mao.0b013e31821f473b

Cited by 89 publications

(77 citation statements)

References 25 publications

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“…An abnormal CVN has been reported in patients in whom the cochlear aperture size is normal or in patients with normal size IAC, or in patients with no associated cochleovestibular malformation [Glastonbury et al, 2002;Adunka et al, 2006Adunka et al, , 2007Buchman et al, 2006;Bradley et al, 2008;McClay et al, 2008;Carner et al, 2009;Warren et al, 2010;Kutz et al, 2011;Pagarkar et al, 2011;Colletti et al, 2014]. Our data highlight the association of normal cochleae, normal cochlear apertures, and normal caliber IAC with severe CVN abnormalities.…”

Section: Imaging Recommendationssupporting

confidence: 47%

“…Recent studies have reported an improvement in auditory skill development and sound awareness in children who had been diagnosed with CVN deficiency and received a CI [Casselman et al, 1997;Ito et al, 1999;Acker et al, 2001;Govaerts et al, 2003;Zanetti et al, 2006;Bradley et al, 2008;Oker et al, 2009;Kang et al, 2010;Warren et al, 2010;Buchman et al, 2011;Kutz et al, 2011;Young et al, 2012]. Clearly, some nerve fibers were available to transmit auditory signals to the brainstem [Casselman et al, 1997;Ozdoğmuş et al, 2004;Warren et al, 2010].…”

Section: Current Imaging Data Does Not Predict Auditorymentioning

confidence: 99%

“…Some children, thought to have absent CVN, nonetheless seemed to benefit from a CI and/or exhibit measurable unaided hearing thresholds [Casselman et al, 1997;Ito et al, 1999;Acker et al, 2001;Govaerts et al, 2003;Zanetti et al, 2006;Bradley et al, 2008;Kang et al, 2010;Warren et al, 2010;Buchman et al, 2011;Kutz et al, 2011;Pagarkar et al, 2011;Zhang et al, 2012;Vincenti et al, 2014;Wu et al, 2014]. The Birman classifications have the benefit of directly cataloging what is seen on imaging and providing an association with outcome, lending it diagnostic usefulness.…”

Section: Introductionmentioning

confidence: 99%

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Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

Kari

Loggins

et al. 2018

Audiol Neurotol

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Objective: Imaging characteristics and hearing outcomes in children with cochleovestibular or cochleovestibular nerve (CVN) abnormalities. Study Design: Retrospective, critical review. Setting: Tertiary referral academic center. Patients: Twenty-seven children with CVN abnormalities with magnetic resonance (MRI) and/or computed tomography (CT). Study Intervention(s): None. Main Outcome Measure(s): Determine the likely presence or absence of a CNV and auditory stimulation responses. Results: Two of 27 cases had unilateral hearing loss, and all others had bilateral loss. Eleven (46%) were identified with a disability or additional condition. Twenty-two (42%) ears received a cochlear implant (CI) and 9 ears (17%) experienced no apparent benefit from the device. MRI acquisition protocols were suboptimal for identification of the nerve in 22 (42%) ears. A likely CVN absence was associated with a narrow cochlear aperture and internal auditory canal and cochlear malformation. Thirteen (48%) children with an abnormal nerve exhibited normal cochleae on the same side. Hearing data were available for 30 ears, and 25 ears (83%) exhibited hearing with or without an assistive device. One child achieved closed set speech recognition with a hearing aid, another with a CI. One child achieved open set speech recognition with a CI. Conclusions: Current imaging cannot accurately characterize the functional status of the CVN or predict an assistive device benefit. Children who would have otherwise been denied a CI exhibited auditory responses after implantation. A CI should be considered in children with abnormal CVN. Furthermore, imaging acquisition protocols need standardization for clear temporal bone imaging.

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Section: Imaging Recommendationssupporting

confidence: 47%

Section: Current Imaging Data Does Not Predict Auditorymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

Kari

Loggins

et al. 2018

Audiol Neurotol

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show abstract

“…Kutz et al [1] found that cochlear nerve hypoplasia or aplasia predicted poor outcome following cochlear implantation in children. A recent study in adult patients demonstrated a positive correlation between cochlear nerve size on magnetic resonance imaging (MRI) and post-operative auditory performance, as well as negative correlation between both the duration and degree of hearing loss and the size of the cochlear nerve [2] .…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Cochlear Nerve Size in Normal-Hearing Adults Using Magnetic Resonance Imaging

et al. 2017

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OBJECTIVE:Cochlear implantation is a clinical and cost-effective treatment for severe hearing loss. Cochlear nerve size assessment by magnetic resonance imaging (MRI) has been investigated for use as a prognostic indicator following cochlear implantation. This study aimed to further that research by assessing nerve size in normal-hearing adults for symmetry. MATERIALS and METHODS:Patients with tinnitus presenting to our center retrospectively had their nerve size assessed by MRI. RESULTS:The study found no significant differences between right and left cochlear nerves in normal-hearing adults, supporting our hypothesis of symmetry in these individuals. This was a previously unproven and uninvestigated hypothesis.CONCLUSION: Nerve size assessment should remain an active area of research in otological disease.

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“…Magnetic resonance imaging (MRI) can directly assess these soft tissue structures responsible for hearing. Therefore, high-resolution brain (or internal auditory canal) MRI has been an important tool in investigating the etiology of deafness and in the selection process for cochlear implantation (CI) [Gleeson et al, 2003;Lapointe et al, 2006;Kutz et al, 2011]. Additionally, brain MRI allows physicians to detect abnormalities of the central nervous system (CNS) that may adversely affect neurological development as well as cognitive function [Bouhadiba et al, 2000;Hart et al, 2008].…”

mentioning

confidence: 99%

The Clinical Significance of Preoperative Brain Magnetic Resonance Imaging in Pediatric Cochlear Implant Recipients

Moon¹,

Kim²,

Park³

et al. 2012

Audiol Neurotol

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Although central nervous system abnormalities are incidentally detected in preoperative brain magnetic resonance imaging (MRI) studies in pediatric cochlear implant (CI) candidates, the clinical significance of the abnormalities remains unclear. We aimed to assess post-implantation auditory and speech performance in patients with brain lesions seen on MRI. Pediatric CI recipients (n = 177) who underwent preoperative MRI scans of the brain between January 2002 and June 2009 were included in this study. Patients with brain lesions on MRI were reviewed and categorized into the following groups: brain parenchymal lesions (focal vs. diffuse), ventriculomegaly, and extra-axial lesion. The main communication mode as well as progress in auditory perception and speech production were evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively. Performance in patients with brain lesions was compared with the age- and sex-matched control group. Various brain lesions were found in 27 out of 177 patients. Children with brain lesions who received CIs showed gradual progress in auditory and speech outcomes for 2 years, though performance was reduced compared with the control group. In addition, there was a significant difference in the main communication mode between the two groups at 2 years following cochlear implantation. This difference was especially significant in patients with diffuse brain parenchymal lesions after further stratification of the brain lesion group. Preoperative brain MRI may have a role in improving the prediction of adverse outcomes in pediatric CI recipients. In particular, children with diffuse brain parenchymal lesions should be counseled regarding the poor prognosis preoperatively, and followed up with special attention.

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Cochlear Implantation in Children With Cochlear Nerve Absence or Deficiency

Cited by 89 publications

References 25 publications

Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

A Comparison of Cochlear Nerve Size in Normal-Hearing Adults Using Magnetic Resonance Imaging

The Clinical Significance of Preoperative Brain Magnetic Resonance Imaging in Pediatric Cochlear Implant Recipients

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