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Robson CD. Conductive Hearing Loss in Children. Neuroimaging Clin N Am 2023; 33:543-562. [PMID: 37741657 DOI: 10.1016/j.nic.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
A variety of congenital and acquired disorders result in pediatric conductive hearing loss. Malformations of the external auditory canal are invariably associated with malformations of the middle ear space and ossicles. Isolated ossicular malformations are uncommon. Syndromes associated with external and middle ear malformations are frequently associated with abnormal development of first and second pharyngeal arch derivatives. Chronic inflammatory disorders include cholesteatoma, cholesterol granuloma, and tympanosclerosis.
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Affiliation(s)
- Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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2
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Abstract
Pattern recognition of specific temporal bone radiological phenotypes, in association with abnormalities in other organ systems, is critical in the diagnosis and management of syndromic causes of hearing loss. Several recent publications have demonstrated the presence of specific radiological appearances, allowing precise genetic and/or syndromic diagnosis, in the right clinical context. This review article aims to provide an extensive but practical guide to the radiologist dealing with syndromic causes of hearing loss.
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Affiliation(s)
- Martin Lewis
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK. felice.d'
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Sorge I, Hirsch FW, Fuchs M, Gräfe D, Dietz A, Sorge M. Imaging in children with hearing loss. ROFO-FORTSCHR RONTG 2023; 195:896-904. [PMID: 37348530 DOI: 10.1055/a-2081-4119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Since the introduction of hearing screening in Germany in 2009, pediatric hearing disorders are detected at an early stage. Early therapy is essential for language development. Imaging plays a central role in diagnosis and therapy planning. METHOD Imaging findings of the most relevant causes of pediatric hearing disorders are presented. Specific attention is given to the method used in each case - CT or MRI. RESULTS AND CONCLUSIONS While CT is the method of choice for conductive hearing loss, a combination of CT and MRI with high-resolution T2-3D sequences has been established as the best diagnostic method for sensorineural hearing loss. The most common causes of conductive hearing loss in childhood are chronic inflammation and cholesteatoma. Congenital malformations of the outer or middle ear are less frequent. In the case of sensorineural hearing loss, the cause is located in the inner ear and/or the cochlear nerve or the cerebrum. In these cases, congenital malformations are the most common cause. KEY POINTS · CT and MRI are necessary to identify morphological causes of hearing disorders and to clarify the possibility of hearing-improving ear surgery or cochlear implantation.. · Contraindications for surgical procedures must be excluded.. · Anatomical variants that may be risk factors for surgery must be described.. CITATION FORMAT · Sorge I, Hirsch F, Fuchs M et al. Imaging diagnostics for childhood hearing loss. Fortschr Röntgenstr 2023; 195: 896 - 904.
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Affiliation(s)
- Ina Sorge
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | | | - Michael Fuchs
- Department of Phoniatrics and Audiology, University Hospital Leipzig, Germany
| | - Daniel Gräfe
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | - Andreas Dietz
- Department of Otolaryngology, University Hospital Leipzig, Germany
| | - Martin Sorge
- Department of Otolaryngology, University Hospital Leipzig, Germany
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Suri N, Singh A, Sharma D. Cochlear Implant in cochlear Hypoplasia type 4 with Chiari Malformation- Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2467-2469. [PMID: 37636597 PMCID: PMC10447647 DOI: 10.1007/s12070-023-03757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/30/2023] [Indexed: 08/29/2023] Open
Abstract
Cochlear hypoplasia type IV is a rare cochlear malformation with hypoplastic middle and apical turns while basal turn develops normally, it often coexist with other genetic mutations. We present a case of 4 year old with chiari malformation type 1 along with bilateral Cochlear hypoplasia type IV who underwent cochlear implantation.
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Affiliation(s)
- Neeraj Suri
- Department of ENT, Gmers medical college, Gandhinagar, Gujarat India
| | - Anshu Singh
- Department of ENT, Gmers medical college, Gandhinagar, Gujarat India
| | - Diva Sharma
- Department of ENT, Gmers medical college, Gandhinagar, Gujarat India
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D'Arco F, Biswas A, Clement E, Rajput K, Juliano AF. Subtle Malformation of the Cochlear Apex and Genetic Abnormalities: Beyond the "Thorny" Cochlea. AJNR Am J Neuroradiol 2023; 44:79-81. [PMID: 36549853 PMCID: PMC9835904 DOI: 10.3174/ajnr.a7746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
With the routine use of high-resolution heavily T2-weighted sequences to evaluate patients with hearing deficits, new, subtle phenotypes of cochlear malformations are being discovered and an increasing number of genotype-phenotype correlations are being found through a reverse phenotype approach, which can help guide geneticists. In this brief report, we present subtle malformations of the apical turn of the cochlea related to 3 genetic mutations, emphasizing the importance of a careful assessment of the cochlear apex.
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Affiliation(s)
- F D'Arco
- From the Department of Radiology (F.D., A.B.)
| | - A Biswas
- From the Department of Radiology (F.D., A.B.)
| | | | - K Rajput
- Audiological Medicine (K.R.), Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, UK
| | - A F Juliano
- Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
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Juliano AF, D'Arco F, Pao J, Picariello S, Clement E, Moonis G, Robson CD. The Cochlea in Branchio-Oto-Renal Syndrome: An Objective Method for the Diagnosis of Offset Cochlear Turns. AJNR Am J Neuroradiol 2022; 43:1646-1652. [PMID: 36175083 PMCID: PMC9731253 DOI: 10.3174/ajnr.a7653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE An "unwound" or "offset" cochlea has been described as a characteristic imaging feature in patients with branchio-oto-renal syndrome, and recently recognized to be associated in particular to those with EYA1 gene mutations. Determination of this feature has traditionally relied on subjective visual assessment. Our aim was to establish an objective assessment method for cochlear offset (the cochlear turn alignment ratio) and determine an optimal cutoff turn alignment ratio value that separates individuals with EYA1-branchio-oto-renal syndrome from those with SIX1-branchio-oto-renal syndrome and healthy controls. MATERIALS AND METHODS Temporal bone CT or MR imaging from 40 individuals with branchio-oto-renal syndrome and 40 controls was retrospectively reviewed. Cochlear offset was determined visually by 2 independent blinded readers and then quantitatively via a standardized technique yielding the cochlear turn alignment ratio. The turn alignment ratio values were compared between cochleae qualitatively assessed as "not offset" and "offset." Receiver operating characteristic analysis was used to determine the ability of the turn alignment ratio to differentiate between these populations and an optimal cutoff turn alignment ratio value. Cochlear offset and turn alignment ratio values were analyzed for each branchio-oto-renal syndrome genotype subpopulation and for controls. RESULTS The turn alignment ratio can accurately differentiate between cochleae with and without an offset (P < .001). The optimal cutoff value separating these populations was 0.476 (sensitivity = 1, specificity = 0.986, J = 0.986). All except 1 cochlea among the EYA1-branchio-oto-renal syndrome subset and all with unknown genotype branchio-oto-renal syndrome had a cochlear offset and a turn alignment ratio of <0.476. All except 1 cochlea among the SIX1-branchio-oto-renal syndrome subset and all controls had no offset and a turn alignment ratio of >0.476. CONCLUSIONS There is a statistically significant difference in turn alignment ratios between offset and nonoffset cochleae, with an optimal cutoff of 0.476. This cutoff value allows excellent separation of EYA1-branchio-oto-renal syndrome from SIX1-branchio-oto-renal syndrome and from individuals without branchio-oto-renal syndrome or sensorineural hearing loss. The turn alignment ratio is a reliable and objective metric that can aid in the imaging evaluation of branchio-oto-renal syndrome.
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Affiliation(s)
- A F Juliano
- From the Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - F D'Arco
- Department of Radiology (F.D.), Great Ormond Street Hospital for Children, London, UK
| | - J Pao
- Department of Radiology (J.P.), Orlando Health, Orlando Regional Medical Center, Orlando, Florida
| | - S Picariello
- Department of General and Specialized Surgery for Women and Children (S.P.), University of Campania "Luigi Vanvitelli," Naples, Italy
- Neuro-Oncology Unit (S.P.), Department of Paediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - E Clement
- Department of Clinical Genetics (E.C.), Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, UK
| | - G Moonis
- Department of Radiology (G.M.), NYU Langone Medical Center, New York, New York
| | - C D Robson
- Department of Radiology (C.D.R.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Biggs K, Crundwell G, Metcalfe C, Muzaffar J, Monksfield P, Bance M. Anatomical and audiological considerations in branchiootorenal syndrome: A systematic review. Laryngoscope Investig Otolaryngol 2022; 7:540-563. [PMID: 35434312 PMCID: PMC9008175 DOI: 10.1002/lio2.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Establish anatomical considerations, audiological outcomes, and optimal management in patients with branchiootic/branchiootorenal syndrome (BO/BOR). Methods Databases reviewed: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. Clinical or radiological studies of patients with BOR syndrome describing either the audiological profile or anatomical changes were included. Articles in which BOR syndrome was associated with other syndromes, and those that were focused only on general and genetic aspects of BOR syndrome were excluded. Articles were assessed using Oxford Centre for Evidence‐Based Medicine (OCEBM) grading system and the Brazzelli risk of bias tool for nonrandomized studies. Results Searches identified 379 articles. Of these, 64 studies met the inclusion criteria, reporting outcomes in 482 patients from at least 95 families. In 308 patients, hearing loss was categorized as sensorineural (29%), conductive (20%), and mixed (51%). Hearing outcomes were variable in terms of onset, pattern, and severity; ranging from mild to profound deafness. One hundred sixty‐nine patients presented with inner ear anomalies, 145 had middle, and 151 had external ear abnormalities. In 44 studies, 58 ear operations were described. Mixed outcomes were reported in patients managed with hearing aids or middle ear surgery; however, successful cochlear implantation was described in all five cases. Conclusion The anatomical and audiological profiles of patients with BO/BOR are variable. A range of surgical procedures were described, however lacked objective outcome measures. Given the range of anatomical variants, management decisions should be made on an individual basis including full audiological and radiological assessment. Level of evidence NA.
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Affiliation(s)
- Kirsty Biggs
- Royal Stoke University Hospital Stoke on Trent UK
- Wolfson Institute of Population Health Queen Mary University of London London UK
| | - Gemma Crundwell
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
| | - Christopher Metcalfe
- Royal Stoke University Hospital Stoke on Trent UK
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Jameel Muzaffar
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
| | - Peter Monksfield
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Manohar Bance
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
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Pao J, D’Arco F, Clement E, Picariello S, Moonis G, Robson C, Juliano A. Re-Examining the Cochlea in Branchio-Oto-Renal Syndrome: Genotype-Phenotype Correlation. AJNR Am J Neuroradiol 2022; 43:309-314. [PMID: 35058298 PMCID: PMC8985666 DOI: 10.3174/ajnr.a7396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Temporal bone imaging plays an important role in the work-up of branchio-oto-renal syndrome. Previous reports have suggested that the unwound or offset cochlea is a highly characteristic marker for branchio-oto-renal syndrome. Our goals were to examine the prevalence of this finding in a branchio-oto-renal syndrome cohort and analyze genetic-phenotypic associations not previously established. MATERIALS AND METHODS This multicenter retrospective study included 38 ears in 19 unrelated individuals with clinically diagnosed branchio-oto-renal syndrome and confirmed mutations in the EYA1 or SIX1 genes. Two blinded neuroradiologists independently reviewed and documented temporal bone imaging findings in 13 categories for each ear. Imaging phenotypes were correlated with genotypes. RESULTS There was excellent interrater agreement for all 13 phenotypic categories (κ ≥ 0.80). Of these, 9 categories showed statistically significant differences between patients with EYA1-branchio-oto-renal syndrome and SIX1-branchio-oto-renal syndrome. Cochlear offset was present in 100% of patients with EYA1-branchio-oto-renal syndrome, but in only 1 ear (12.5%) among patients with SIX1-branchio-oto-renal syndrome. A short thorny appearance of the cochlear apical turn was observed in most patients with SIX1-branchio-oto-renal syndrome. CONCLUSIONS An offset cochlea is associated with the EYA1-branchio-oto-renal syndrome genotype. The SIX1-branchio-oto-renal syndrome genotype is associated with a different cochlear phenotype that almost always is without offset and has a short thorny tip as the apical turn. Therefore, cochlear offset is not a characteristic marker for all patients with branchio-oto-renal syndrome. The lack of a cochlear offset in a patient with clinically suspected branchio-oto-renal syndrome does not exclude the diagnosis and, in fact, may be predictive of the SIX1 genotype.
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Affiliation(s)
- J. Pao
- From the Department of Radiology (J.P.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - E. Clement
- Department of Clinical Genetics (E.C.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - S. Picariello
- Department of Women, Child and General and Specialized Surgery (S.P.), University of Campania “Luigi Vanvitelli,” Naples, Italy,Department of Paediatric Oncology (S.P.), Neuro-Oncology Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - G. Moonis
- Department of Radiology (G.M.), Columbia University Irving Medical Center, New York, New York
| | - C.D. Robson
- Department of Radiology (C.D.R.), Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - A.F. Juliano
- Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
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Nonsyndromic Congenital Causes of Sensorineural Hearing Loss in Children: An Illustrative Review. AJR Am J Roentgenol 2021; 216:1048-1055. [PMID: 33502224 DOI: 10.2214/ajr.20.23160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this article is to provide an illustrative review of nonsyndromic congenital causes of sensorineural hearing loss (SNHL) in children. CONCLUSION. Early recognition and treatment are essential in maximizing developmental outcomes in children with congenital SNHL. Because imaging plays an integral role in identifying underlying causes of SNHL, it is imperative that radiologists be able to recognize, describe, and appropriately categorize the spectrum of congenital inner ear malformations in children.
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Nada A, Agunbiade SA, Whitehead MT, Cousins JP, Ahsan H, Mahdi E. Cross-Sectional Imaging Evaluation of Congenital Temporal Bone Anomalies: What Each Radiologist Should Know. Curr Probl Diagn Radiol 2020; 50:716-724. [PMID: 32951949 DOI: 10.1067/j.cpradiol.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/09/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022]
Abstract
Hearing loss in pediatric age group is associated with many congenital temporal bone disorders. Aberrant development of various ear structures leads into either conductive or sensorineural hearing loss. Knowledge of the embryology and anatomical details of various compartments of the ear help better understanding of such disorders. In general, abnormalities of external and middle ears result in conductive hearing loss. Whereas abnormalities of inner ear structures lead into sensorineural hearing loss. These abnormalities could occur as isolated or part of syndromes. Temporal bone disorders are a significant cause of morbidity and developmental delays in children. Imaging evaluation of children presented with hearing loss is paramount in early diagnosis and proper management planning. Our aim is to briefly discuss embryology and anatomy of the pediatric petrous temporal bones. The characteristic imaging features of commonly encountered congenital temporal bone disorders and their associated syndromes will be discussed.
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Affiliation(s)
- A Nada
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO.
| | - S A Agunbiade
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - M T Whitehead
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC; George Washington University Hospital, Washington, DC
| | - J P Cousins
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - H Ahsan
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - E Mahdi
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
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Oghenekaro E, Ibekwe U. Hearing loss in the pediatric age group. SAHEL MEDICAL JOURNAL 2020. [DOI: 10.4103/smj.smj_30_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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D'Arco F, Youssef A, Ioannidou E, Bisdas S, Pinelli L, Caro-Dominguez P, Nash R, Siddiqui A, Talenti G. Temporal bone and intracranial abnormalities in syndromic causes of hearing loss: an updated guide. Eur J Radiol 2019; 123:108803. [PMID: 31891841 DOI: 10.1016/j.ejrad.2019.108803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/11/2019] [Accepted: 12/15/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe in detail the temporal bone and brain findings in both common and rare syndromic causes of hearing loss, with the purpose of broadening among radiologists and enhance the current understanding of distinct imaging features in paediatric patients with syndromic hearing loss. METHODS A detailed search of electronic databases has been conducted, including PubMed, Ovid Medline, Scopus, Cochrane Library, Google Scholar, National Institute for Health and Care Excellence (NICE), Embase, and PsycINFO. RESULTS Syndromic causes of hearing loss are characterised by different and sometimes specific abnormalities in the temporal bone. CONCLUSION A complete knowledge of the image findings in the temporal bones, brain, skull and other body regions is critical for the optimal assessment and management of these patients.
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Affiliation(s)
- Felice D'Arco
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Adam Youssef
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | | | - Sotirios Bisdas
- Department of Neuroradiology, University College of London, London, UK
| | - Lorenzo Pinelli
- Neuroradiology Unit, Spedali Civili Di Brescia, Brescia, Italy
| | | | - Robert Nash
- Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital for Children, London, UK
| | - Ata Siddiqui
- Department of Neuroradiology,Guy's and St.Thomas Hospital, London, UK
| | - Giacomo Talenti
- Neuroradiology Unit, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Baird SM, Nguyen K, Bhatia DDS, Wei BPC. Inner ear and retrocochlear pathology on magnetic resonance imaging for sudden and progressive asymmetrical sensorineural hearing loss. ANZ J Surg 2018; 89:738-742. [PMID: 30497101 DOI: 10.1111/ans.14957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND In sudden and asymmetrical progressive sensorineural hearing loss (SNHL), magnetic resonance imaging (MRI) is required to evaluate retrocochlear pathology and, with recent advances in MRI techniques, inner ear pathology. Given the limited literature regarding inner ear pathology associated with SNHL, we aimed to assess the incidence of retrocochlear and inner ear pathology, and congenital malformation on MRI in sudden SNHL (SSNHL) and progressive SNHL. METHODS A total of 987 acoustic neuroma (AN) protocol MRI internal acoustic meatus studies performed at our institution to investigate SNHL between January 2013 and December 2015 inclusive were identified. Following categorization for indication of SSNHL versus progressive asymmetrical SNHL, MRIs with retrocochlear or inner ear abnormality, congenital malformation or other otology-related abnormality were identified, and further data were collected for these patients including patient demographics, associated symptomatology, management and outcomes. RESULTS In SSNHL, aetiological abnormality on MRI was identified for 6.9% patients with AN present on 4% overall. 3.2% of MRIs for progressive asymmetrical SNHL identified a causative lesion with 2.3% of scans overall diagnosing AN. The incidence of congenital inner ear malformation on MRI in the setting of SSNHL and progressive asymmetrical SNHL are 1.7% and 0.6%, respectively. CONCLUSION This is the first retrospective study of inner ear MRI abnormalities in both SSNHL and progressive asymmetrical SNHL in Australia and one of the largest cohorts published in the literature to date. MRI must be performed in the setting of SNHL to ensure aforementioned and rarer causative lesions are identified.
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Affiliation(s)
- Samantha M Baird
- Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Kevin Nguyen
- Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Daman D S Bhatia
- Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Benjamin P C Wei
- Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.,Department of Otolaryngology, The University of Melbourne, Melbourne, Victoria, Australia
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14
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Hsu A, Desai N, Paldino MJ. The Unwound Cochlea: A Specific Imaging Marker of Branchio-Oto-Renal Syndrome. AJNR Am J Neuroradiol 2018; 39:2345-2349. [PMID: 30385470 DOI: 10.3174/ajnr.a5856] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/04/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Branchio-oto-renal syndrome is an important syndromic cause of hearing loss. Our aim was to determine the test characteristics of the unwound cochlea on temporal bone CT for the diagnosis of branchio-oto-renal syndrome in a cohort of children with hearing loss. MATERIALS AND METHODS Patients were identified retrospectively with a clinical diagnosis of branchio-oto-renal syndrome and CT imaging of the temporal bones. Age-matched controls were also identified with sensorineural hearing loss not related to a diagnosis of branchio-oto-renal syndrome and CT imaging of the temporal bones. All examinations were reviewed by 2 neuroradiologists blinded to the diagnosis of branchio-oto-renal syndrome versus controls for the absence/presence of an unwound cochlea defined as anteromedial rotation and displacement of the middle and apical turns away from the basal turn. RESULTS The final study group comprised 9 patients with branchio-oto-renal syndrome (age range, 1-14 years; mean age, 8.0 ± 4.3 years) and 50 control patients (age range, 1-16 years; mean age, 7.9 ± 4.1 years). The cochlea was subjectively abnormal in all 9 patients. In 8 patients (89%), imaging demonstrated a typical unwound cochlear morphology. By contrast, none of the control subjects demonstrated an unwound cochlea on either side. Statistically, the unwound cochlea was significantly more frequent in the branchio-oto-renal group compared with controls (P < .001). The unwound cochlea was 89% sensitive and 100% specific for the diagnosis of branchio-oto-renal syndrome. CONCLUSIONS The unwound cochlea is a specific imaging marker of branchio-oto-renal syndrome. These findings further support the diagnostic accuracy and therefore the utility of temporal bone imaging in the diagnosis of this disorder.
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Affiliation(s)
- A Hsu
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - N Desai
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - M J Paldino
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas.
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Adadey SM, Awandare G, Amedofu GK, Wonkam A. Public Health Burden of Hearing Impairment and the Promise of Genomics and Environmental Research: A Case Study in Ghana, Africa. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2018; 21:638-646. [PMID: 29140768 DOI: 10.1089/omi.2017.0145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hearing impairment (HI) is one of the most disabling conditions of major global health burden that contributes adversely to the social and economic development of a country, if not managed properly. A proper assessment of the nationwide burden and etiology of HI is instrumental in the prevention, treatment, and management of the condition. This article sought to perform an expert review of HI in Ghana to determine the present knowledge of its burden and possible causes of the condition. A literature search was conducted in PubMed using the following keywords: "hearing loss" OR "hearing impairment" OR "deafness" AND "Ghana." The literature was scanned until July 20, 2017, with specific inclusion of targeted landmark and background articles on HI. From the search, 18 of out 5869 articles were selected and considered for the review. The results of the search indicated that there were no extensive studies to determine the national burden of HI in Ghana. However, the few studies assessed suggested that the disease is either acquired or inherited. The burden of acquired HI was higher in adults than children, women than men, and people working in a noisy environment. Regarding the genetic cause, specific founder mutations in GJB2 gene (R143W, L79P, V178A, R184Q, A197S, I203K, and L214P) was the only identified genetic cause of HI in Ghana, but the other HI genes were not investigated. There has been some modest effort to study HI in Ghana, but comprehensive studies on the genetic and environmental etiologies (using the "multi-OMICS" approaches), classification, and burden of HI on Ghana are needed.
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Affiliation(s)
- Samuel Mawuli Adadey
- 1 West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana , Accra, Ghana
| | - Gordon Awandare
- 1 West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana , Accra, Ghana
| | | | - Ambroise Wonkam
- 3 Division of Human Genetics, Department of Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa
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van Beeck Calkoen EA, Merkus P, Goverts ST, van de Kamp JM, Mulder MF, Sanchez Aliaga E, Hensen EF. Evaluation of the outcome of CT and MR imaging in pediatric patients with bilateral sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2018; 108:180-185. [PMID: 29605351 DOI: 10.1016/j.ijporl.2018.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/09/2018] [Accepted: 02/12/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the clinically relevant abnormalities as visualized on CT and MR imaging in children with symmetric and asymmetric bilateral sensorineural hearing loss (SNHL), in relation to age and the severity of hearing loss. STUDY DESIGN Retrospective cohort study. SETTING Tertiary referral otology and audiology center. PATIENTS AND DIAGNOSTIC INTERVENTIONS From January 2006 until January 2016, a total of 207 children diagnosed with symmetric and asymmetric bilateral SNHL were included. They underwent CT and/or MR imaging for the evaluation of the etiology of their hearing loss. MAIN OUTCOME MEASURES Radiologic abnormalities associated with SNHL. RESULTS 302 scans were performed in 207 children (median age of 0.8 years old) with bilateral SNHL. The most frequently identified cause of bilateral SNHL was a malformation of the labyrinth. The combined diagnostic yield of CT and MR imaging was 32%. The diagnostic yield of MR (34%) was considerably higher than that of CT (20%). We found a higher rate of abnormalities in children with profound hearing loss (41%) compared to milder hearing loss (8-29%), and in asymmetric SNHL (52%) compared to symmetric SNHL (30%). CONCLUSION Imaging is essential in the etiologic evaluation of children with bilateral SNHL. The highest diagnostic yield is found in children with bilateral asymmetric SNHL or profound SNHL. Based on our findings, MR is the primary imaging modality of choice in the etiological evaluation of children with bilateral SNHL because of its high diagnostic yield.
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Affiliation(s)
- E A van Beeck Calkoen
- Department of Otolaryngology-Head and Neck Surgery, Section Ear and Hearing VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1)
| | - P Merkus
- Department of Otolaryngology-Head and Neck Surgery, Section Ear and Hearing VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1)
| | - S T Goverts
- Department of Otolaryngology-Head and Neck Surgery, Section Ear and Hearing VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1)
| | - J M van de Kamp
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1)
| | - M F Mulder
- Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1)
| | - E Sanchez Aliaga
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - E F Hensen
- Department of Otolaryngology-Head and Neck Surgery, Section Ear and Hearing VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, The Netherlands(1); Department of Otolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
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DeMarcantonio M, Choo DI. Radiographic Evaluation of Children with Hearing Loss. Otolaryngol Clin North Am 2015; 48:913-32. [DOI: 10.1016/j.otc.2015.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cochlear implantation in patients with inner ear bone malformations with posterior labyrinth involvement: an exploratory study. Eur Arch Otorhinolaryngol 2015; 273:893-8. [DOI: 10.1007/s00405-015-3652-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
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Effectiveness of cochlear implant in inner ear bone malformations with anterior labyrinth involvement. Int J Pediatr Otorhinolaryngol 2015; 79:369-73. [PMID: 25613931 DOI: 10.1016/j.ijporl.2014.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To study electrical stimulation, auditory functionality, and language development in patients with inner ear malformations involving the anterior labyrinth who underwent cochlear implantation. STUDY DESIGN Retrospective case review. SETTING Reference hospital for cochlear implantation. PATIENTS Review of 14 cases of severe hearing loss with major (common cavity deformity and cochlear hypoplasia) or minor (e.g., incomplete partition and basal turn aplasia) malformations. INTERVENTIONS After cochlear implantation, data were gathered on the threshold (THR) and maximum comfort level (MCL) of the electrical stimulation and the number of functioning electrodes. Auditory responses to speech (EARS protocol) subtests were used to evaluate auditory functionality and language acquisition at 6, 12, and 24 months post-implantation. Tests used were: LIP profile, MTP (3, 6 and 12 words), OLD (open set test) and CLD (close set test). Results were compared with findings in a control group of 28 cochlear implantation patients without these malformations and with congenital hearing loss. RESULTS The mean THR was 11.02μC in patients with malformations versus 3.5μC in those without, a significant difference. The THR also significantly differed between groups with major and minor malformations. Fewer functioning electrodes were used in patients with malformations. Auditory functionality scores were best in controls than in patients with malformations, who scored ≤50%, finding the lowest scores in those with major malformations. CONCLUSION Patients with inner ear malformations undergoing cochlear implantation require greater stimuli to obtain an auditory response and have worse auditory functionality outcomes; these differences are greater in those with major versus minor malformations Nevertheless, cochlear implantation appears to be beneficial for all patients with these malformations to a greater or lesser extent.
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Noto D, Funama Y, Kitajima M, Utsunomiya D, Oda S, Yamashita Y. Optimizing radiation dose by varying age at pediatric temporal bone CT. J Appl Clin Med Phys 2015; 16:5082. [PMID: 25679165 PMCID: PMC5689997 DOI: 10.1120/jacmp.v16i1.5082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 11/23/2022] Open
Abstract
We performed retrospective (first‐step) and prospective (second‐step) studies to evaluate the body information and noise on temporal bone computed tomography (CT) images in efforts to identify the optimized tube current yielding the greatest reduction in the radiation exposure of pediatric patients undergoing temporal bone CT studies. Our first‐step study included 90 patients subjected to temporal bone CT. We recorded displayed volume CT dose index (CTDIvol), displayed dose‐length product (DLP), image noise, and the patient age and sex. We then calculated the optimized tube current value with and without IR corresponding to the children's age based on the ratio of the noise on images from individuals older than 18 years. In our second‐step study, we enrolled 23 pediatric patients and obtained CT scans using our optimized protocol. In both studies we applied identical analysis techniques. The diagnostic image quality was confirmed reading reports and a neuroradiologist. Our first‐step study indicated that the mean image noise in children assigned to five ascending age groups from 2 to 12 years ranged from 167.59 to 211.44 Hounsfield units (HU). In the second‐step study, the mean image noise in each age group was almost the same as the expected noise value and the diagnostic image quality was acceptable. The dose reduction was ranged from 57.5% to 37.5%. Optimization of the tube current–time product allows a radiation reduction without a loss in image quality in pediatric patients undergoing temporal bone CT. PACS number: 87.57.qp, 87.57.cm
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Affiliation(s)
- Daichi Noto
- Department of Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan.
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El Beltagi A, Elsherbiny M, El-Nil H. Congenital X-linked Stapes Gusher Syndrome. Neuroradiol J 2012; 25:486-8. [DOI: 10.1177/197140091202500412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 07/02/2012] [Indexed: 11/17/2022] Open
Abstract
X-Linked sensorineuronal hearing loss (SNHL) is a rare but recognized cause of bilateral SNHL associated with CSF gusher. We report a case presenting a varied imaging spectrum and clinical scenario of a one year old boy with unilateral profound hearing loss and recurrent meningitis due to spontaneous oval window gusher. Imaging showed a unilateral abnormality, with the fistula leaking from the oval window into the middle ear cleft.
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Affiliation(s)
- A.H. El Beltagi
- Radiology Department, Al-Sabah Hospital; Sulaibikhat, Kuwait
| | - M.M. Elsherbiny
- Radiology Department, Al-Jahra Hospital; Sulaibikhat, Kuwait
| | - H. El-Nil
- Radiology Department, Al-Sabah Hospital; Sulaibikhat, Kuwait
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Yiin RSZ, Tang PH, Tan TY. Review of congenital inner ear abnormalities on CT temporal bone. Br J Radiol 2011; 84:859-63. [PMID: 21849370 DOI: 10.1259/bjr/18998800] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aetiology of profound hearing loss in children is complex and multifactorial. Congenital inner ear abnormality is a major cause of hearing loss in children. CT temporal bone imaging is the modality of choice in the investigation of hearing loss. Recognising the congenital abnormalities of the inner ear guides the clinician's management of the condition. This pictorial essay illustrates the congenital abnormalities of the inner ear on high resolution CT temporal bone images and correlation with developmental arrest during embryology.
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Affiliation(s)
- R S Z Yiin
- Department of Diagnostic Radiology, Changi General Hospital, Singapore.
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Nauer CB, Zubler C, Weisstanner C, Stieger C, Senn P, Arnold A. Radiation dose optimization in pediatric temporal bone computed tomography: influence of tube tension on image contrast and image quality. Neuroradiology 2011; 54:247-54. [DOI: 10.1007/s00234-011-0961-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 09/12/2011] [Indexed: 01/21/2023]
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Moreira NC, Teixeira J, Raininko R, Wikstrom J. The ear in fetal MRI: what can we really see? Neuroradiology 2011; 53:1001-8. [DOI: 10.1007/s00234-011-0938-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 07/18/2011] [Indexed: 11/24/2022]
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Senggen E, Laswed T, Meuwly JY, Maestre LA, Jaques B, Meuli R, Gudinchet F. First and second branchial arch syndromes: multimodality approach. Pediatr Radiol 2011; 41:549-61. [PMID: 20924574 DOI: 10.1007/s00247-010-1831-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 07/21/2010] [Accepted: 08/06/2010] [Indexed: 12/27/2022]
Abstract
First and second branchial arch syndromes (BAS) manifest as combined tissue deficiencies and hypoplasias of the face, external ear, middle ear and maxillary and mandibular arches. They represent the second most common craniofacial malformation after cleft lip and palate. Extended knowledge of the embryology and anatomy of each branchial arch derivative is mandatory for the diagnosis and grading of different BAS lesions and in the follow-up of postoperative patients. In recent years, many new complex surgical approaches and procedures have been designed by maxillofacial surgeons to treat extensive maxillary, mandibular and external and internal ear deformations. The purpose of this review is to evaluate the role of different imaging modalities (orthopantomogram (OPG), lateral and posteroanterior cephalometric radiographs, CT and MRI) in the diagnosis of a wide spectrum of first and second BAS, including hemifacial microsomia, mandibulofacial dysostosis, branchio-oto-renal syndrome, Pierre Robin sequence and Nager acrofacial dysostosis. Additionally, we aim to emphasize the importance of the systematic use of a multimodality imaging approach to facilitate the precise grading of these syndromes, as well as the preoperative planning of different reconstructive surgical procedures and their follow-up during treatment.
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Affiliation(s)
- Elodie Senggen
- Radiology Department, University Hospital of Lausanne, Lausanne, Switzerland.
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Cochlear abnormalities associated with enlarged vestibular aqueduct anomaly. Int J Pediatr Otorhinolaryngol 2009; 73:1682-5. [PMID: 19775757 DOI: 10.1016/j.ijporl.2009.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 08/23/2009] [Accepted: 08/26/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The objective of this study is to examine the correlation between enlarged vestibular aqueduct (EVA) anomaly and other inner ear anomalies such as cochlear dysplasia, vestibulocochlear dysplasia and modiolar hypoplasia. METHODS Retrospective chart review, with institutional review board approval, of patients with EVA who received treatment at Primary Children's Medical Center or University Hospital at the University of Utah, between 1997 and 2006. Review of radiographs was done to evaluate for the presence of EVA and other inner ear anomalies. RESULTS Twenty patients (40 ears) were included in the study, 17 patients had bilateral EVA and three patients had unilateral EVA. There were 10 females and 10 males. The average age of all patients at the time of initial diagnosis was 1.7 years (0-6 years). Thirty-seven ears were shown to have EVA (92.5%). Of those ears with EVA, 29 (78.4%) had one or more inner ear anomalies. Twenty-three (62.2%) ears had cochlear dysplasia, six (16.2%) had vestibulocochlear dysplasia, and 18 (48.7%) had modiolar hypoplasia. CONCLUSIONS Using small field of view, thin section CT and/or MR imaging, cochleovestibular abnormalities are commonly identified in association with EVA.
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