Does the Width of the Bony Cochlear Nerve Canal Predict the Outcomes of Cochlear Implantation?

Chung, Juyong; Jang, Jeong Hun; Chang, Sun O; Song, Jae-Jin; Cho, Sung Woo; Kim, So Young; Lee, Jun Ho; Oh, Seung Ha

doi:10.1155/2018/5675848

Cited by 19 publications

(35 citation statements)

References 28 publications

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“…Consequently, a CA stenosis appeared to be a criterion for a negative outcome of the cochlear implant surgery, indicating that patients with stenotic CA demonstrate poorer cochlear implants results than patients with normal CA. Chung et al 43 compared the post-cochlear implant speech performances among 3 groups of various CA diameters (< 1.4 mm; 1.4–2.0 mm; > 2.0 mm). CND occurred more frequently in the group with a diameter of < 1.4 mm which, also showed a worse post-cochlear implant outcome.…”

Section: Discussionmentioning

confidence: 99%

Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation

Orzan

Pizzamiglio

Gregori

et al. 2021

Sci Rep

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The use of neonatal hearing screening has enabled the identification of congenital unilateral sensorineural hearing loss (USNHL) immediately after birth, and today there are several intervention options available to minimize potential adverse effects of this disease, including cochlear implantation. This study aims to analyze the characteristics of the inner ear of a homogeneous group of congenital non-syndromic USNHL to highlight the features of the inner ear, which can help in clinical, surgical, and rehabilitative decision-making. A retrospective chart review was carried out at a tertiary referral center. Systematic diagnostic work-up and rigorous inclusion–exclusion criteria were applied to 126 children with unilateral hearing impairment, leading to a selection of 39 strictly congenital and non-syndromic USNHL cases, undergoing computed tomography (CT) and magnetic resonance (MR) imaging studies. The frequency and type of malformations of the inner ear in USNHL and unaffected contralateral ears were assessed, with an in-depth analysis of the deficiency of the cochlear nerve (CND), the internal auditory canal (IAC) and the cochlear aperture (CA). Inner ear anomalies were found in 18 out of 39 (46%) of the USNHL patients. In 1 subject, the anomalies were bilateral, and the CND resulted in the predominant identified defect (78% of our abnormal case series), frequently associated with CA stenosis. Only 3 out of 14 children with CND presented stenosis of the IAC. CND and CA stenosis (and to a much lesser extent IAC stenosis) are a frequent association within congenital and non-syndromic USNHL that could represent a distinct pathological entity affecting otherwise healthy infants. In the context of a diagnostic work-up, the evaluation with CT and MRI measurements should take place in a shared decision-making setting with thorough counseling. Both imaging techniques have proven useful in differentiating the cases that will most likely benefit from the cochlear implant, from those with potentially poor implant performance.

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Section: Discussionmentioning

confidence: 99%

Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation

Orzan

Pizzamiglio

Gregori

et al. 2021

Sci Rep

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“…Several factors related to the CI outcome in patients with CND have been reported. Speech performance or aided threshold with CI was relatively poor when patients showed cochlear nerve aplasia 14,16,18 , low grades of IAC nerve 16,19 , narrow bony cochlear nerve canal 20 , no response to the intracochlear electrically evoked auditory brain stem response (EABR) 21 , or smaller diameter of vestibulocochlear nerve (VCN) than FN at the cerebellopontine angle (CPA) 21,22 . These factors were helpful for predicting whether the CI outcome would be good.…”

Section: Introductionmentioning

confidence: 99%

A Predictive Model for Cochlear Implant Outcome in Children with Cochlear Nerve Deficiency

Han

Suh

Park

et al. 2019

Sci Rep

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The outcome of cochlear implantation (CI) in patients with cochlear nerve deficiency (CND) is variable, resulting in a wide range of speech perception performance, from degrees of environmental sound perception to conversation without lip-reading. Twenty-five cochlear implantees with CND were enrolled retrospectively to determine the factors correlated with CI outcome in patients with CND and to develop a predictive model for CI outcome. CI outcome was evaluated using the Categories of Auditory Performance (CAP) score at 2 years after CI. Patients with negative auditory brainstem response (ABR) showed a significantly lower CAP score than those with positive ABR (2.5 ± 1.7, 4.8 ± 0.7; p = 0.001). The area ratio of vestibulocochlear nerve (VCN) to facial nerve (FN) at the cerebellopontine angle on magnetic resonance images was positively correlated with CI outcome (p < 0.001). With multiple regression analysis, a predictive equation accounting for 66% of variance of CAP score at 2 years after CI was . We found that preoperative ABR and area ratio of VCN to FN at the cerebellopontine angle could predict CI outcome in patients with CND. Preoperative counselling based on our predictive model might be helpful to determine treatment modality for auditory rehabilitation and which ear to implant.

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“…Recently, several studies have demonstrated a correlation between BCNC or IAC diameter and post-CI auditory outcome. 25,26 They attributed poor post-CI outcomes of narrow BCNC or IAC to CND. In this study, 3 children with cochlear nerve hypoplasia were excluded at the outset.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Measurement of Internal Auditory Canal in Pediatric Cochlear Implantation

Kim

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: The aims of this study were to clarify the clinical value of the bony cochlear nerve canal (BCNC) and internal auditory canal (IAC) in children with bilateral sensorineural hearing loss (b-SNHL) and to reveal the correlation between these parameters and outcomes after cochlear implantation (CI). Methods: Ninety-four ears with b-SNHL that received CI and 100 ears with normal hearing were enrolled. Parameters of IAC and pre- and post-CI categories of auditory performance scores were analyzed. Results: The width of the BCNC and the width, height, and length of the IAC were shorter in the b-SNHL group. BCNC and IAC width were associated with b-SNHL. The calculated cutoff values for BCNC and IAC width were 2.055 mm in the BCNC and 4.245 mm in the IAC, setting the sensitivity to 90%. Patients with narrow BCNCs and IACs had significantly worse post-CI auditory performance. Conclusions: BCNC and IAC widths were narrower in children with b-SNHL than in normal-hearing children. Narrow BCNC and IAC width had a negative impact on post-CI outcomes. The proposed cutoff values for BCNC and IAC width were meaningful when predicting the auditory outcome after CI, especially considering both.

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Does the Width of the Bony Cochlear Nerve Canal Predict the Outcomes of Cochlear Implantation?

Cited by 19 publications

References 28 publications

Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation

Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation

A Predictive Model for Cochlear Implant Outcome in Children with Cochlear Nerve Deficiency

Clinical Value of Measurement of Internal Auditory Canal in Pediatric Cochlear Implantation

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