Journal
OTOLOGY & NEUROTOLOGY
Volume 35, Issue 2, Pages 241-245Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0b013e3182a437b3
Keywords
Cochlear implantation; Preoperative imaging; Sensorineural hearing loss
Categories
Funding
- NCATS NIH HHS [UL1 TR000117, KL2 TR000116] Funding Source: Medline
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Objective: Preoperative evaluation of cochlear implant candidate includes routine imaging to identify anatomic abnormalities that may preclude or complicate implantation, such as cochlear aplasia, absent/narrowed internal auditory canals, cochlear ossificans, or significant traumatic fracture. The aim of this study is to determine if preoperative imaging is necessary in select cochlear implant candidates, thus defraying cost and ionizing radiation. Study Design: Retrospective chart review. Setting: Tertiary referral facility. Patients: Adult patients with progressive sensorineural hearing loss without evidence of head trauma, meningitis, or congenital hearing loss who underwent cochlear implantation. Interventions: Diagnostic and therapeutic. Main Outcome Measures: Preoperative radiologic abnormalities, deviation from standard cochlear implant operation. Results: One hundred eighteen cochlear implants met inclusion criteria; 23.7% of CT scans had a documented abnormality, including chronic otitis media (14.4%), otosclerosis (4.2%), and an enlarged vestibular aqueduct (3.4%). There were 6 eventful surgeries in patients with normal documented CT scan. Events included multiple insertion attempts (3.4%), CSF leak (2.5%), and no apparent round window (2.5%). In every case, a cochlear implant was able to be placed successfully. Conclusion: In the appropriately selected patient, preoperative imaging is not necessary as it does not impact the cochlear implant surgery and will defray cost and ionizing radiation.
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