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Khalifa R, Touska P, Pai I, Padormo F, Goh V, Hajnal JV, Connor SEJ. Magnetic resonance imaging evaluation of cochlear and vestibular nerve calibre: a case-control study in Ménière's disease and endolymphatic hydrops. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08895-4. [PMID: 39152300 DOI: 10.1007/s00405-024-08895-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE To compare the calibre of the cochlear (CN), superior vestibular (SVN) and inferior vestibular (IVN) nerves on magnetic resonance imaging (MRI), both between Ménière's Disease (MD) ears and clinical controls, and between inner ears with and without endolymphatic hydrops (EH) on MRI. METHODS A retrospective case-control study evaluated patients undergoing MRI for suspected hydropic ear disease from 9/2017 to 8/2022. The CN, SVN, IVN and facial nerve (FN) diameters and cross-sectional areas (CSA) were measured on T2-weighted sequences whilst EH was evaluated on delayed post-gadolinium MRI. Absolute nerve calibre (and that relative to the FN) in unilateral definite MD ears (2015 Barany criteria) was compared to that in both asymptomatic contralateral ears and clinical control ears. Nerve calibre in ears with severe cochlear and vestibular EH was compared to ears without EH. t tests or Wilcoxon signed-rank test/Mann-Whitney U test were applied (p < 0.001). RESULTS 173 patients (mean age 51.3 ± 15.1, 65 men) with 84 MD (62 unilateral) and 62 clinical control ears were studied. Absolute and relative CN dimensions were decreased in both MD ears (CSA and diameter) and the contralateral asymptomatic ears (CSA) when compared to clinical controls (p < 0.001). Absolute nerve dimensions were reduced in both severe vestibular EH (CN, IVN and SVN) and severe cochlear EH (CN) (p < 0.001), however this was not evident when adjusted according to facial nerve calibre. CONCLUSION There is decreased absolute CN calibre in both symptomatic and asymptomatic MD ears as well as ears with severe cochlear and vestibular EH on MRI.
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Affiliation(s)
- Radwa Khalifa
- Faculty of Medicine, Helwan University, Cairo, Egypt
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Philip Touska
- Department of Radiology, Guy's and St Thomas' Hospital, London, UK
| | - Irumee Pai
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Ear, Nose and Throat Surgery, Guy's and St Thomas' Hospital, London, UK
| | - Francesco Padormo
- Medical Physics, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Hyperfine, Inc., Guilford, CT, USA
| | - Vicky Goh
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Radiology, Guy's and St Thomas' Hospital, London, UK
| | - Joseph V Hajnal
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Steve E J Connor
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
- Department of Radiology, Guy's and St Thomas' Hospital, London, UK.
- Neuroradiology Department, Ruskin Wing, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
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Reimann K, Klose U, Ehrenpfordt U, Thangavelu K, Schulze M. Detection of Reduced Diameter of the Cochlear Nerve in Long-term Deaf Patients Quantified With Semiautomatic Measurement of Nerve Cross-sectional Area Using 3T MRI Data. OTOLOGY & NEUROTOLOGY OPEN 2024; 4:e047. [PMID: 38533346 PMCID: PMC10962875 DOI: 10.1097/ono.0000000000000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/22/2023] [Indexed: 03/28/2024]
Abstract
Hypothesis High-resolution parallel transmit T2 sampling perfection with application optimized contrast using different flip angle evolution sequence with improved edge discrimination and semiautomatic determination of nerve cross-sectional area (CSA) can be used to evaluate nerve degeneration in the inner auditory canal (IAC) in long-term deaf patients. Background In patients with hearing loss, temporal bone MRI is routinely acquired to evaluate the morphology of the nerves within the IAC. Earlier studies have shown that the diameter of the cochlear nerve can be used as prognostic marker for the auditory performance after cochlear implantation in postlingually deaf patients. Methods Eighty-two consecutive MRI scans were analyzed using a semiautomatic tool to measure CSA of cranial nerves in the IAC. Results were correlated with patient history and audiology testing as well as with age and gender. Results There was a significant reduced CSA of the cochlear nerve in ears with moderate-to-profound hearing loss and deafness compared with ears with normal hearing, but no significant difference in ears with mild-to-moderate hearing loss compared with normal hearing. In detail, normal hearing ears had a CSA of 1.23 ± 0.11 mm2, whereas ears with pantonal hearing loss of more than 40 dB had 1.02 ± 0.05 mm2 (P = 0.026). Maximal CSA of the facial nerve was not different among all groups (average, 1.04 mm2 ± 0.03; linear regression, P = 0.001) and stable with age. However, vestibular nerve CSA decreased significantly with age (average, 1.78 ± 0.05 mm2; linear regression, P = 0.128). Conclusions In long-term deaf patients, smaller the diameter of cochlear nerve is the more severe the hearing loss is. The new semiautomatic tool can primarily be used to assess nerve diameter and possibly determine ears with nerve degeneration.
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Affiliation(s)
- Katrin Reimann
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Ulrike Ehrenpfordt
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Marburg, Germany
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Swarup A, Karakkandy V, Chappity P, Naik S, Behera SK, Parida PK, Grover M, Gupta G, Giri PP, Sarkar S, Pradhan P, Samal DK, Kallyadan Veetil A, Adhikari A, Nayak S. Comparing accuracy of cochlear measurements on magnetic resonance imaging and computed tomography: A step towards radiation-free cochlear implantation. J Otol 2023; 18:208-213. [PMID: 37877072 PMCID: PMC10593569 DOI: 10.1016/j.joto.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are commonly employed in pre-operative evaluation for cochlear implant surgery. However, with a decrease in the age of implantation, even minor radiation exposure can cause detrimental effects on children over their lifetime. The current study compares different cochlear measurements from CT and MRI scans and evaluates the feasibility of using only an MRI scan for radiological evaluation before cochlear implantation. Methods A longitudinal observational study was conducted on 94 ears/47 children, employing CT and MRI scans. The CT and MRI scan measurements include, A value, B value, Cochlear duct length (CDL), two-turn cochlear length, alpha and beta angles to look for cochlear orientation. Cochlear nerve diameter was measured using MRI. The values were compared. Results The mean difference between measurements from CT and MRI scans for A value, B value, CDL, and two-turn cochlear length values was 0.567 ± 0.413 mm, 0.406 ± 0.368 mm, 2.365 ± 1.675 mm, and 2.063 ± 1.477 mm respectively without any significant difference. The alpha and beta angle measures were comparable, with no statistically significant difference. Conclusion The study suggests that MRI scans can be the only radiological investigation needed with no radiation risk and reduces the cost of cochlear implant program in the paediatric population. There is no significant difference between the measurements obtained from CT and MRI scans. However, observed discrepancies in cochlear measurements across different populations require regionally or race-specific standardized values to ensure accurate diagnosis and precision in cochlear implant surgery. This aspect must be addressed to ensure positive outcomes for patients.
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Affiliation(s)
- Anurita Swarup
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Vinusree Karakkandy
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Preetam Chappity
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Sanjay Kumar Behera
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Pradipta Kumar Parida
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Mohnish Grover
- Department of ENT, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - Gaurav Gupta
- Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Prajna Paramita Giri
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Saurav Sarkar
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Pradeep Pradhan
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Dillip Kumar Samal
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Aswathi Kallyadan Veetil
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Asutosh Adhikari
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Saurav Nayak
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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High-frequency Cochlear Nerve Deficit Region: Relationship With Deaf Duration and Cochlear Implantation Performance in Postlingual Deaf Adults. Otol Neurotol 2021; 42:844-850. [PMID: 33617191 DOI: 10.1097/mao.0000000000003092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To analyze the changes of cochlear nerve diameter and the presence of a cochlear nerve deficit at a high-frequency region and investigate their effects on cochlear implant (CI) performance in postlingual deaf adults. STUDY DESIGN Retrospective. SETTING Tertiary care academic center. PATIENTS Eighty-three postlingual deaf adults with no labyrinthine anomalies or cognitive deficits who received a CI with perimodiolar electrodes from a single manufacturer. MAIN OUTCOMES AND MEASURES We evaluated the changes of cochlear nerve diameter and the presence of a "tail sign," defined as identifiable nerve fibers originating from the far basal turn of the cochlea, which represents the presence of cochlear nerve at a high-frequency region in magnetic resonance imaging, on monosyllabic word recognition scores. RESULTS The cochlear nerve diameter showed a positive correlation with word recognition scores (maximum diameter, R2 = 0.26, p < 0.01; minimum diameter, R2 = 0.26, p < 0.01), but a negative correlation with deaf duration. Recipients with a positive tail sign performed better (73 ± 19%) than those without (45 ± 24%, p < 0.01). A positive tail sign was more commonly found in good performers (52 of 62, 84%) than in poor performers (5 of 21, 24%, p < 0.01). CONCLUSIONS Favorable outcomes could be anticipated in postlingual deaf adults with a large cochlear nerve diameter and positive tail sign. A presence of cochlear nerve at a high-frequency region may be an imaging marker for predicting good CI performance.
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Kim MB, Lim J, Moon IJ. Anatomical and Pathological Findings of Magnetic Resonance Imaging in Idiopathic Sudden Sensorineural Hearing Loss. J Audiol Otol 2020; 24:198-203. [PMID: 32927937 PMCID: PMC7575921 DOI: 10.7874/jao.2020.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives We sought to evaluate the diagnostic and prognostic value of measurable parameters of internal auditory canal (IAC) magnetic resonance imaging (MRI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Subjects and Methods We retrospectively reviewed the patients with ISSNHL who underwent IAC MRI from January 2008 to March 2019. Measurable parameters of IAC MRI, such as the diameter of the IAC, bony cochlear nerve canal, and cross-sectional area of the cochlear nerve, were measured by a single examiner. These parameters were then compared between the affected and healthy sides. Inner-ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis were also evaluated. The relationship between the surveyed parameters and the diagnosis of ISSNHL was assessed. Results A total of 208 patients with ISSNHL were included. The measured parameters of IAC MRI were not different between the affected and healthy sides and were also not associated with the diagnosis of ISSNHL. However, inner-ear abnormalities of IAC MRI in ISSNHL displayed a significant association with worse hearing before and after treatment. An age that was older than 40 years also correlated with poorer outcomes. Further, inner-ear abnormalities were more frequently detected when IAC MRI was performed early after ISSNHL onset. Conclusions Patients with ISSNHL and inner ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis identified via IAC MRI may experience poorer hearing outcomes. To detect such abnormal findings, it is recommended to perform IAC MRI early after the onset of ISSNHL.
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Affiliation(s)
- Min Bum Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.,Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.,Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
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Özdemir M, Kavak RP. Morphometric analysis of facial and cochlear nerves in normal-hearing ears using 3D-CISS. J Otol 2020; 14:136-140. [PMID: 32742273 PMCID: PMC7387841 DOI: 10.1016/j.joto.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose The aim of the current study was to establish a normative data set for the morphometric parameters of the facial nevre (FN) and cochlear nevre (CN) according to age and sex in the adult population, using 3-dimensional constructive interference in steady state (3D-CISS) sequence on magnetic resonance imaging. Methods We retrospectively analyzed 157 ears of 102 adults with no hearing impairment, facial palsy or Ménière's disease. The vertical (VD) and horizontal (HD) diameters as well as cross-sectional areas (CSAs) of the FNs and CNs were measured on the parasagittal oblique image created using the axial 3D-CISS sections passing through the internal acoustic canal. We related the measurement results with side, sex and age. Results The mean VD, HD and CSA of the FNs were 1.09 ± 0.18 mm, 0.84 ± 0.17 mm, and 0.75 ± 0.27 mm2, respectively, whereas those of the CNs were 1.34 ± 0.17 mm, 1 ± 0.15 mm and 1.06 ± 0.3 mm2, respectively. There was no statistically significant difference between the morphometric parameters of both the nerves according to side or sex (P > 0.05). However, except for the CSA of the FNs among males, we found a statistically significant decrease in all the morphometric parameters of both the nerves with ageing (P < 0.05). Conclusion The normative morphometric data obtained in this study can be beneficial in clinical applications for sensorineural hearing loss, facial palsy and Ménière's disease.
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Affiliation(s)
- Meltem Özdemir
- Corresponding author. Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, Ziraat mah. Şehit Ömer Halisdemir cad. No:20, Altındağ/Ankara, Turkey.
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Flatz WH, Henneberger A, Reiser MF, Gürkov R, Ertl-Wagner B. In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears. J Vis Exp 2018. [PMID: 29553505 DOI: 10.3791/57091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Analysis of neural structures in Menière's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.
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Affiliation(s)
| | - Annika Henneberger
- Department of Otorhinolaryngology - Head and Neck Surgery, SLK-Kliniken Heilbronn GmbH
| | | | - Robert Gürkov
- Department of Otorhinolaryngology Head and Neck Surgery, Ludwig-Maximilians-University Hospital Munich, German Centre for Vertigo and Balance Disorder
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S. J, A. BT, Rangasami R. A novel segmentation of cochlear nerve using region growing algorithm. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
OBJECTIVE To assess cochlear implant (CI) outcomes, and factors affecting outcomes, for children with aplasia/ hypoplasia of the cochlea nerve. We also developed a new grading system for the nerves of the internal auditory meatus (IAM) and cochlea nerve classification. STUDY DESIGN Retrospective patient review. SETTING Tertiary referral hospital and cochlear implant program. PATIENTS Children 0 to 16 years inclusive with a CI who had absent/hypoplastic cochlea nerve on magnetic resonance imaging (MRI). INTERVENTION Cochlear implant. MAIN OUTCOME MEASURES MRI, trans-tympanic electrical auditory brainstem response, intraoperative electrical auditory brainstem response, Neural Response Telemetry, Categories of Auditory Perception score, Main mode of communication. RESULTS Fifty CI recipients (26 males and 24 females) were identified, 21 had bilateral CIs, 27 had developmental delay. MRI showed cochlea nerve aplasia in 64 ears, hypoplasia in 25 ears, and a normal nerve in 11 ears. Main mode of communication was analyzed for 41 children: 21 (51%) used verbal language (15 speech alone, 5 speech plus some sign, 1 bilingual in speech and sign), and 20 (49%) used sign language (10 sign alone, 9 sign plus some speech, 1 tactile sign). Seventy-three percent of children used some verbal language. Cochlea nerve aplasia/ hypoplasia and developmental delay were both significant factors affecting main mode of communication. Categories of Auditory Performance scores were available for 59 CI ears; 47% with CN Aplasia (IAM nerve grades 0-III) and 89% with CN hypoplasia (IAM nerve grade IV) achieved Categories of Auditory Performance scores of 5 to 7 (some verbal understanding) (p = 0.003). CONCLUSION Our results are encouraging and useful when counselling families regarding the likelihood of language outcomes and auditory understanding.
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Morphometric evaluation of facial and vestibulocochlear nerves using magnetic resonance imaging: comparison of Menière’s disease ears with normal hearing ears. Eur Arch Otorhinolaryngol 2017; 274:3029-3039. [DOI: 10.1007/s00405-017-4616-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 05/19/2017] [Indexed: 01/11/2023]
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Connor SEJ. Contemporary imaging of auditory implants. Clin Radiol 2017; 73:19-34. [PMID: 28388970 DOI: 10.1016/j.crad.2017.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/25/2017] [Accepted: 03/02/2017] [Indexed: 12/14/2022]
Abstract
There have been significant advances in the diversity and effectiveness of hearing technologies in recent years. Implanted auditory devices may be divided into those that stimulate the cochlear hair cells (bone conduction devices and middle ear implants), and those that stimulate the neural structures (cochlear implants and central auditory implants). Contemporary preoperative and postoperative imaging may be used to help individualise implant selection, optimise surgical technique and predict auditory outcome. This review will introduce the concepts behind auditory implants, and explains how imaging is increasingly used to aid insertion and evaluation of these devices.
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Affiliation(s)
- S E J Connor
- Neuroradiology Department, King's College Hospital, London, UK; Radiology Department, Guy's and St Thomas' Hospital, London, UK.
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12
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Naguib NNN, Hey C, Shaaban MS, Elabd AM, Hassan HHM, Gruber-Rouh T, Kaltenbach B, Harth M, Ackermann H, Stöver T, Vogl TJ, Nour-Eldin NEA. Assessment of the cochlear nerve to facial nerve size ratio using MR multiplanar reconstruction of the internal auditory canal in patients presenting with acquired long-standing hearing loss. Br J Radiol 2017; 90:20160870. [PMID: 28368665 DOI: 10.1259/bjr.20160870] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To test using the facial nerve as a reference for assessment of the cochlear nerve size in patients with acquired long-standing sensorineural hearing loss (SNHL) using MRI multiplanar reconstruction. METHODS The study was retrospectively performed on 86 patients. Group 1 (study group, n = 53) with bilateral long-standing SNHL. Group 2 (control group, n = 33) without hearing loss. The nerve size was measured by drawing a region of interest around the cross-sectional circumference of the nerve in multiplanar reconstruction images. RESULTS No significant correlation was noted between the cochlear nerve and facial nerve size, and the patient's age, gender and weight (p > 0.05). In Group 1, the mean ratio of the cochlear to facial nerve size was 0.99 ± 0.30 (range: 0.52-1.86) and 1.12 ± 0.35 (range: 0.34-2.3) for the right and left sides, respectively. In Group 2, it was 1.18 ± 0.23 (range: 0.78-1.71) and 1.25 ± 0.25 (range: 0.85-1.94) for the right and left sides, respectively. The cochlear nerve size was statistically (p = 0.0004) smaller in Group 1 than in Group 2. CONCLUSION The cochlear nerve size and the cochlear to facial nerve size ratio are significantly smaller in patients with acquired long-standing SNHL. Advances in knowledge: The facial nerve can be used as a reference for assessment of the cochlear nerve in patients with acquired long-standing SNHL.
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Affiliation(s)
- Nagy N N Naguib
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany.,3 Department of Radiology, Faculty of Medicine, Alexandria university, Alexandria, Egypt
| | - Constanze Hey
- 2 Department of Otolaryngology, Frankfurt University Hospital, Frankfurt, Germany
| | - Mohamed S Shaaban
- 3 Department of Radiology, Faculty of Medicine, Alexandria university, Alexandria, Egypt
| | - Amr M Elabd
- 3 Department of Radiology, Faculty of Medicine, Alexandria university, Alexandria, Egypt
| | - Hebatallah H M Hassan
- 3 Department of Radiology, Faculty of Medicine, Alexandria university, Alexandria, Egypt
| | - Tatjana Gruber-Rouh
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - Benjamin Kaltenbach
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - Marc Harth
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - Hanns Ackermann
- 4 Department of Biomedical Statistics, Frankfurt University Hospital, Frankfurt, Germany
| | - Timo Stöver
- 2 Department of Otolaryngology, Frankfurt University Hospital, Frankfurt, Germany
| | - Thomas J Vogl
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nour-Eldin A Nour-Eldin
- 1 Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany.,3 Department of Radiology, Faculty of Medicine, Alexandria university, Alexandria, Egypt
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Some Remarks on Imaging of the Inner Ear: Options and Limitations. Clin Neuroradiol 2015; 25 Suppl 2:197-203. [DOI: 10.1007/s00062-015-0422-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
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Lou J, Gong WX, Wang GB. Cochlear nerve diameters on multipoint measurements and effects of aging in normal-hearing children using 3.0-T magnetic resonance imaging. Int J Pediatr Otorhinolaryngol 2015; 79:1077-80. [PMID: 25959404 DOI: 10.1016/j.ijporl.2015.04.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine differences in diameter of cochlear nerves (CN) among three measurement points at the midpoint of the internal auditory canal (IAC), IAC fundus and cochlear aperture, and to evaluate whether nerve size varies with age. METHODS A total of 336 normal-hearing ears of 201 children were assessed, who were underwent 3D-Fiesta sequence scanning of inner ear. All subjects were divided into 12 groups at one year interval. The diameter measurements of CN were obtained in the midpoint of the IAC, IAC fundus and cochlear aperture respectively on the axial and oblique sagittal images of 3.0-T MRI. SPSS 18.0 statistics software was applied for data analysis, and all of the data showed a normal distribution and expressed in x ± s. RESULTS The diameters of normal-hearing children's CN at the midpoint of the IAC, IAC fundus and cochlear aperture were respectively: 1.12 ± 0.08 mm, 1.05 ± 0.06 mm, 0.87 ± 0.14 mm, and there were significant differences among the three measuring points (F = 527.57, p < 0.05). The diameters of the CN had no significant difference (p > 0.05) in age groups, gender and sides (p > 0.05), and there was no correlation between the diameters of normal children's CN and age (r is -0.129, 0.128 and -0.113, respectively). CONCLUSION The diameters of normal-hearing children's CN change with different points of the internal auditory canal, of which the maximum value is in the midpoint of the IAC, followed by the IAC fundus, and the cochlear aperture is at the minimum; moreover the normal size doesn't change with age.
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Affiliation(s)
- Jing Lou
- Shandong Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan 250012, PR China
| | - Wu-Xian Gong
- Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021, PR China
| | - Guang-Bin Wang
- Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021, PR China.
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Giesemann AM, Raab P, Lyutenski S, Dettmer S, Bültmann E, Frömke C, Lenarz T, Lanfermann H, Goetz F. Improved imaging of Cochlear nerve hypoplasia using a 3-tesla variable flip-angle turbo spin-echo sequence and a 7-cm surface coil. Laryngoscope 2013; 124:751-4. [DOI: 10.1002/lary.24300] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/23/2013] [Accepted: 06/18/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Anja M. Giesemann
- Department of Diagnostic and Interventional Neuroradiology; Hannover Medical School; Hannover Germany
| | - Peter Raab
- Department of Diagnostic and Interventional Neuroradiology; Hannover Medical School; Hannover Germany
| | - Stefan Lyutenski
- Department of Otorhinolaryngology; Hannover Medical School; Hannover Germany
| | - Sabine Dettmer
- Department of Diagnostic and Interventional Radiology; Hannover Medical School; Hannover Germany
| | - Eva Bültmann
- Department of Diagnostic and Interventional Neuroradiology; Hannover Medical School; Hannover Germany
| | - Cornelia Frömke
- Institute of Biostatistics; Hannover Medical School; Hannover Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology; Hannover Medical School; Hannover Germany
| | - Heinrich Lanfermann
- Department of Diagnostic and Interventional Neuroradiology; Hannover Medical School; Hannover Germany
| | - Friedrich Goetz
- Department of Diagnostic and Interventional Neuroradiology; Hannover Medical School; Hannover Germany
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Clemmens CS, Guidi J, Caroff A, Cohn SJ, Brant JA, Laury AM, Bilaniuk LT, Germiller JA. Unilateral cochlear nerve deficiency in children. Otolaryngol Head Neck Surg 2013; 149:318-25. [PMID: 23678279 DOI: 10.1177/0194599813487681] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Cochlear nerve deficiency (CND) is increasingly diagnosed in children with sensorineural hearing loss (SNHL). We sought to determine the prevalence of CND, its imaging characteristics, and correlations with audiologic phenotype in children with unilateral SNHL. DESIGN Case series with chart review. SETTING Tertiary pediatric hospital. SUBJECTS/METHODS In 128 consecutive children with unilateral SNHL who underwent high-resolution magnetic resonance imaging, the diameters, area, and signal intensity of the cochlear nerve (CN) were measured and normalized to the ipsilateral facial nerve. Presence of CND was determined by comparison to normative data. Relationships among hearing loss severity, progression, and nerve size were investigated. RESULTS Cochlear nerve deficiency was present in 26% of children with unilateral SNHL. Its prevalence was higher (48%) in severe to profound SNHL, especially when in infants (100%). Width of the bony cochlear nerve canal (BCNC) correlated strongly with relative CN diameter, density, and area (R = 0.5); furthermore, a narrow BCNC (<1.7 mm) strongly predicted CND. Severity of hearing loss modestly correlated with nerve size, although significant variability was observed. Progression never occurred unless there were other inner ear malformations, whereas in the non-CND group, it occurred in 22%. Ophthalmologic abnormalities were very common (67%) in CND children, particularly oculomotor disturbances. CONCLUSION Cochlear nerve deficiency is a common cause of unilateral SNHL, particularly in congenital unilateral deafness. Width of the BCNC effectively predicts CND, a finding useful when only computed tomography imaging is available. In an ear with CND, hearing can be expected to remain stable over time. Diagnosis should prompt evaluation by an ophthalmologist.
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Affiliation(s)
- Clarice S Clemmens
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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NAKAMICHI R, YAMAZAKI M, IKEDA M, ISODA H, KAWAI H, SONE M, NAKASHIMA T, NAGANAWA S. Establishing Normal Diameter Range of the Cochlear and Facial Nerves with 3D-CISS at 3T. Magn Reson Med Sci 2013; 12:241-7. [DOI: 10.2463/mrms.2013-0004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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18
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Fundakowski CE, Anderson J, Angeli S. Cross-Sectional Vestibular Nerve Analysis in Vestibular Neuritis. Ann Otol Rhinol Laryngol 2012; 121:466-70. [DOI: 10.1177/000348941212100707] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: We examined the association between the size and cross-sectional area of the superior vestibular nerve as measured on constructive interference in steady-state (CISS) parasagittal magnetic resonance imaging (MRI) and the vestibular nerve function as measured by electronystagmography. Methods: The retrospective observational cohort study took place at an academic tertiary referral center. Twenty-six patients who met established clinical and electronystagmographic criteria for vestibular neuritis and who underwent parasagittal CISS MRI were identified. Two blinded investigators measured vestibular nerve height and width bilaterally at the level of the fundus of the internal auditory canal and calculated the cross-sectional nerve areas. The inter-rater reliability and agreement were analyzed. Symptom duration, age, and gender were also examined. Results: A statistically significant decrease was observed in both vestibular nerve cross-sectional area and height as compared to the contralateral vestibular nerve. A non–statistically significant trend was observed for a relative decreased cross-sectional nerve area with increased age, as well as a decrease in nerve area with an increase in symptom duration. Conclusions: Decreases in both vestibular nerve cross-sectional area and height are observed in patients with unilateral vestibular neuritis as measured on parasagittal CISS MRI.
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Kang WS, Hyun SM, Lim HK, Shim BS, Cho JH, Lee KS. Normative diameters and effects of aging on the cochlear and facial nerves in normal-hearing Korean ears using 3.0-tesla magnetic resonance imaging. Laryngoscope 2012; 122:1109-14. [PMID: 22374919 DOI: 10.1002/lary.23184] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 11/19/2011] [Accepted: 12/05/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To assess the normative size of the cochlear nerve (CN) and facial nerve (FN) in normal-hearing ears and to determine whether nerve size varies with age. STUDY DESIGN Cross-sectional. METHODS We included 169 ears with normal hearing between 2005 and 2010. The height, width, and cross-sectional area (CSA) of the CN and FN in the middle of the internal auditory canal were measured on oblique sagittal images of 3.0-T magnetic resonance imaging. Results were compared by age. Young subjects were divided into three age groups, 0-5, 6-10, and 11-15 years. Subjects over age 40 years were divided into groups at 10-year intervals. RESULTS Mean age was 32.6 years (range, 0.75-79 years). We found that the CN had significantly greater vertical (1.10 ± 0.21 mm vs. 0.95 ± 0.21 mm) and horizontal (1.11 ± 0.20 mm vs. 1.03 ± 0.22 mm) diameters than the FN. The CSA of the CN was larger than that of the FN (0.98 ± 0.33 mm(2) vs. 0.79 ± 0.31 mm(2) ). Except for the CN vertical diameter, there were no significant differences between right and left ears. Sex did not affect the nerve size. Although the CN was not affected by age, the FN vertical diameter and CSA of children <5 years were significantly smaller than those of children aged >5 years. The size of the two nerves did not differ among groups over age 40 years. CONCLUSIONS The CN is not affected by age in normal-hearing ears. The FN vertical diameter and CSA of children <5 years are smaller than those of older children.
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Affiliation(s)
- Woo Seok Kang
- Department of Otolaryngology, Gangneung Asan Hospital, Gangneung, Gangwon, South Korea
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Differences in Cochlear Nerve Cross-Sectional Area between Normal Hearing and Postlingually Deafened Patients on MRI. Otolaryngol Head Neck Surg 2010; 144:64-6. [DOI: 10.1177/0194599810390884] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives. To demonstrate that parasagittal constructive interference in steady state (CISS) magnetic resonance imaging (MRI) can be used to accurately measure cochlear nerve cross-sectional area and thereby evaluate for statistically significant differences in the cochlear nerve cross-sectional areas of postlingually deafened and normal-hearing adults. Study Design. Cross-sectional study. Setting. Tertiary care medical center. Subjects and Methods. Parasagittal CISS MRIs of postlingually profoundly deafened cochlear implant candidates and normal-hearing patients at a tertiary care academic medical center between 2006 and 2009 were retrospectively identified. Two independent and blinded investigators measured the cochlear nerve height and width and calculated the cross-sectional area [π(H/2)(W/2)] at the fundus of the internal auditory canals. Measurements of both investigators were analyzed for reliability and agreement with an Altman plot, and deafened patient measurements were compared with results of the normal-hearing patients via Wilcoxon rank sum tests. Results. The cochlear nerve cross-sectional area of postlingually deafened patients (mean ± SD = 0.61 ± 0.16 mm2) was less than normal-hearing patients (0.94 ± 0.28 mm2). The difference was statistically significant ( P = .002). There was good agreement between independent observer measurements. Conclusion. Parasagittal CISS MRI can be used to measure the cochlear nerve with good interobserver agreement, and there is a significant difference between the cross-sectional area of postlingually deafened and normal-hearing adults. The cross-sectional area may correlate with residual spiral ganglion cells and provide a prognostic indicator for post–cochlear implant performance, which is the focus of our ongoing research.
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