Feasibility Of Cochlear Implantation Research Articles

The feasibility of cochlear implantation in early infancy

To determine the key image anatomical parameters that are relevant to cochlear implantation (CI) using temporal bone high-resolution computed tomography (HRCT) scans and to identify age group differences in order to provide image anatomical support for early CI. The data of 346 temporal bone HRCTs of 173 children from 5 months to 18 years of age were retrospectively selected and reviewed. Parameters of the human temporal bone that are relevant to CI key surgical steps include mastoid thickness (MT), the facial recess width (FRW), and an angle representing the round window visibility. All measurements are performed on axial images. There was no significant difference in the above morphological values by gender (p>0,05). Two-sided FRW was not significantly different (p>0,05), but MT and angle A were significantly different (p<0,001). FRW and angle were independent of age (p>0,05). However, MT had been found to exhibit postnatal development. The linear function of MT were calculated as y=2463 × group(s)+20,574 (p<0,001). Based on preoperative imaging analysis at different ages, middle ear development was stable at 5 months of age, allowing early CI in infancy with severe to severe hearing loss at this age. These data must be considered exploratory and more extensive clinical studies are needed.

A prospective study on the feasibility of cochlear implantation during the coronavirus disease 2019 crisis and trends of assessment: experience in a UK centre.

To demonstrate the feasibility of continuing cochlear implantation during the coronavirus disease 2019 crisis and to report on trends of referrals via the neonatal hearing screening programme. A prospective case series was conducted on children who underwent cochlear implantation during the coronavirus disease 2019 crisis in the UK and a sample of referrals via the neonatal hearing screening programme. A step-by-step description of peri-operative management is included. Regionally, between February and May 2020, 106 babies were referred via the neonatal hearing screening programme to paediatric audiology. Eleven children were operated on during the coronavirus disease 2019 study period. None of the 11 children developed coronavirus symptoms. It is widely recognised that the demands of managing the current pandemic may compromise screening, clinical assessment and elective surgery. Time-sensitive issues such as cancer management have gained prominence, but a similar need exists for timely paediatric cochlear implantation. Implantation in the paediatric population during the coronavirus disease 2019 pandemic is feasible with careful planning.

The role of preoperative imaging for auditory implants in children.

&lt;b&gt;Introduction:&lt;/b&gt; Preoperative imaging, besides audiological evaluation, plays a major role in evaluation of candidacy for auditory implants, and in particular cochlear implants. It is essential to assess whether the basic criteria necessary for implantation are met. Diagnostic imaging is crucial not only in determining candidacy, but also determining the feasibility of cochlear implantation as it allow to anticipate surgical difficulties which could preclude or complicate the implantation of the device. The aim of the study is to present the protocol for the evaluation of preoperative imaging studies with particular focus on the factors potentially affecting clinical decisions in children qualified for cochlear implantation. &lt;br&gt;&lt;b&gt;Material and method:&lt;/b&gt; Preoperative imaging studies of 111 children performed prior to cochlear implantation were analyzed: high-resolution computed tomography (HRCT) of temporal bones and MRI. The assessment was made according to the presented protocol. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Pathologies and anomalies identified during the assessment of preoperative imaging studies significantly altered clinical decisions in 30% of patients. In the study group, in 17% of patients inner ear malformations were identified. 2.7% of children were disqualified from a cochlear implantation due to severe congenital inner ear malformations. 9% of the patients have had bacterial meningitis. In 50% of them difficulties related to complete or progressive cochlear ossification occurred. In 4.5% of patients less common surgical approaches other than mastoidectomy with a posterior tympanotomy were applied. &lt;br&gt;&lt;b&gt;Discussion:&lt;/b&gt; Preoperative imaging allow for the identification of significant pathologies and anomalies affecting qualification decisions and further treatment. HRCT and MRI are complementary to each other for preoperative imaging. The two modalities in combination allow accurate and optimal evaluation of the anatomical structures prior to implantation. Inner ear malformations and cochlear ossification following meningitis are relatively frequently encountered in children qualified for a cochlear implant.

Hearing rehabilitation after subtotal cochleoectomy using a new, perimodiolar malleable cochlear implant electrode array: a preliminary report

PurposeWe here report about the first surgical experience and audiological outcome using a new, perimodiolar malleable cochlear implant electrode array for hearing rehabilitation after subtotal cochleoectomy for intralabyrinthine schwannoma (ILS).MethodBased on a cochlear implant with MRI compatibility of the magnet in the receiver coil up to 3 T, a cochlear implant electrode array was developed that is malleable and can be placed perimodiolar after tumor removal from the cochlea via subtotal cochleoectomy. Malleability was reached by incorporating a nitinol wire into the silicone of the electrode array lateral to the electrode contacts. The custom-made device was implanted in four patients with intracochlear, intravestibulocochlear or transmodiolar schwannomas. Outcome was assessed by evaluating the feasibility of the surgical procedure and by measuring sound field thresholds and word recognition scores.ResultsAfter complete or partial tumor removal via subtotal cochleoectomy with or without labyrinthectomy, the new, perimodiolar malleable electrode array could successfully be implanted in all four patients. Six months after surgery, the averaged sound field thresholds to pulsed narrowband noise in the four patients were 36, 28, 41, and 35 dB HL, and the word recognitions scores for monosyllables at 65 dB SPL were 65, 80, 70, and 25% (one patient non-German speaking).ConclusionThe surgical evaluation demonstrated the feasibility of cochlear implantation with the new, perimodiolar malleable electrode array after subtotal cochleoectomy. The audiological results were comparable to those achieved with another commercially available type of perimodiolar electrode array from a different manufacturer applied in patients with ILS.

High-resolution computerized tomography and Magnetic Resonance Imaging (MRI) in preoperative evaluation of cochlear implant patients

Context Preoperative cross-sectional imaging evaluation of cochlear implant patients is critically important in deciding whether the patient is suitable for implantation and in choosing the side of implantation. Aims The aim of this prospective study was to determine the incidence of structural cochlear anomalies in patients with congenital profound bilateral sensorineural hearing loss, who were being evaluated for the feasibility of cochlear implantation. Settings and design This was a prospective observational nonrandomized study. Patients and methods A total of 26 patients with congenital profound bilateral sensorineural hearing loss, who were being evaluated for feasibility of cochlear implantation were included in this study. These patients were evaluated with high-resolution computerized tomography of the temporal bone and MRI for incidence of structural cochlear anomalies. Results The incidence of structural cochlear anomalies, excluding cochlear nerve aplasia, in patients with congenital profound bilateral sensorineural hearing loss, who were being evaluated for the feasibility of cochlear implantation was 50%. Conclusion This study highlights the importance of preoperative radiological scanning in the assessment of patients undergoing cochlear implantation. It provides vital information on cochlear status and in ruling out noncochlear causes where cochlear implantation is not feasible or contraindicated.

Cochlear implantation in chronic ear disease

Profound hearing loss can be accompanied by or be a result of chronic otitis media. Cochlear implantation in patients with chronic otitis media is often resisted because of possible problems associated with the introduction of foreign material into a septic space, which is a potential pathway to the intracranial space. However, the well-established benefits of cochlear implants and improved surgical techniques have encouraged discussions on the feasibility of cochlear implantation in the presence of chronic otitis media. Generally, special surgical techniques, in addition to implantation, are necessary to eradicate the infection and to protect the electrode array in the radical cavity. In this study, we describe our experience of cochlear implantation in patients with chronic ear disease, and propose management principles.