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Fan H, Li D, Xie W, Wang J, Cheng H, Kong W. Developmental Auditory and Speech-Language Performance in Pediatric Cochlear Implantation Recipients with Stable White Matter Lesions. Brain Sci 2023; 13:1540. [PMID: 38002500 PMCID: PMC10669646 DOI: 10.3390/brainsci13111540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
To analyze the association between stable asymptomatic white matter lesions (WMLs) and the cochlear implantation (CI) effect in congenitally deaf children, 43 CI children with stable asymptomatic WMLs determined via preoperative assessments and 86 peers with normal white matter were included. Outcome measurements included closed-set Mandarin Chinese (tone, disyllable, and sentence) recognition tests; categories of auditory performance (CAPs); and speech intelligibility rating (SIR) scales at 1, 12, and 24 months post-CI. Generalized estimating equation (GEE) models were used to analyze the association between WML and outcomes. In the WML group (control group), median CAP and SIR scores were 5 (5) and 4 (4) with mean rates of tone, disyllable, and sentence recognition of 84.8% (89.0%), 87.9% (89.7%), and 85.8% (88.0%) at 24 months post-CI, respectively. Auditory and speech performance improved significantly with implant use. Compared to their peers in the control group, for the participants with stable asymptomatic WMLs, auditory and speech abilities were not significantly different (p > 0.05). Stable asymptomatic WMLs might not be associated with poor auditory and speech intelligibility post-CI, which indicates that it is feasible to use comprehensive assessments to screen suitable candidates with WMLs who are likely to present with a good prognosis.
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Affiliation(s)
- Huiru Fan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dan Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wen Xie
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Huamao Cheng
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Brain MRI findings of prelingually deaf children and cochlear implant outcome: Preliminary results. Int J Pediatr Otorhinolaryngol 2022; 162:111302. [PMID: 36122419 DOI: 10.1016/j.ijporl.2022.111302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/03/2022] [Accepted: 08/28/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the incidence of brain abnormalities in a cohort of prelingually deaf children and whether these abnormalities can impact the hearing outcomes of patients eligible for cochlear implantation (CI). METHODS We performed a retrospective review of consecutive medical charts of prelingually deaf children under 12 years of age who underwent brain magnetic resonance imaging (MRI) during their preoperative workup for CI surgery. We used the category of auditory performance (CAP) test and the speech intelligibility rating (SIR) test to assess the hearing and speech performance of the children, respectively. RESULTS The MRIs of 285 patients, 174 boys and 111 girls with a mean age of 36.4 (±16) months, were evaluated for this study. We identified 31 patients with abnormal findings (10.88%): (17/31) (54.8%) had MRI brain abnormalities, (9/31) (29%) had inner ear anomalies, and (5/31) (16.1%) had both inner ear and brain abnormalities. The most frequent inner ear anomaly was an enlarged vestibular aqueduct, while white matter lesions were the most common brain abnormality. The CAP and SIR mean score of patients with inner ear anomalies was slightly, but not significantly, higher than those of patients with brain abnormalities. CONCLUSION CAP and SIR scores were not significantly different in children with brain abnormalities than inner ear anomalies. These patients can still benefit from CI to improve their overall hearing and speech performance.
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Zhang J, Sawaf T, Anne S, Pham GN, Pakanati K, Raol N, Ongkasuwan J, Georgopoulos R. Imaging in pediatric bilateral sensorineural hearing loss: Diagnostic yield with computed tomography versus magnetic resonance imaging. Int J Pediatr Otorhinolaryngol 2021; 147:110778. [PMID: 34049106 DOI: 10.1016/j.ijporl.2021.110778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the findings and compare the diagnostic yield of computed tomography (CT) versus magnetic resonance imaging (MRI) in children with bilateral sensorineural hearing loss (BSNHL). STUDY DESIGN Multi-institutional retrospective review. SETTING Three tertiary referral centers. METHODS A multi-institutional retrospective chart review was performed in patients under the age of 18 years with BSNHL (diagnosis codes 389.00-389.22) who underwent both CT and MRI from 2010 to 2012. An abnormal imaging finding was defined as an abnormality of the cochleovestibular or central nervous system known to directly correlate with sensorineural hearing loss. Diagnostic yield of CT versus MRI was compared by McNemar's test. RESULTS Of 2081 charts reviewed, 313 patients met inclusion criteria. The diagnostic yield of CT and MRI were 25% and 18%, respectively. Approximately one-quarter of patients had an abnormal finding on CT or MRI. The concordance rate was 92%. CT was more likely to yield an abnormal finding versus MRI (p-value = 0.0001). The most common findings on CT were cochlear and semicircular canal abnormalities. On MRI, the most common findings were cochlear nerve aplasia/hypoplasia and semicircular canal abnormalities. CONCLUSIONS This study evaluates and directly compares the diagnostic yield of CT versus MRI for pediatric BSNHL. While both modalities have important and often complementary diagnostic utility, CT had superior diagnostic yield in identifying abnormalities associated with BSNHL.
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Affiliation(s)
- Jessica Zhang
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Tuleen Sawaf
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Samantha Anne
- Cleveland Clinic, Head and Neck Institute, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Gina Nhu Pham
- Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin, Suite 640, Houston, TX, 77030, USA
| | - Keerthana Pakanati
- Long Medical School, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | - Nikhila Raol
- Emory University, Department of Otolaryngology - Head & Neck Surgery, 550 Peachtree Street NE, Atlanta, GA, 30308, USA; Children's Healthcare of Atlanta, Division of Pediatric Otolaryngology, 2015 Uppergate Dr. NE, Atlanta, GA, 30322, USA
| | - Julina Ongkasuwan
- Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin, Suite 640, Houston, TX, 77030, USA
| | - Rachel Georgopoulos
- Cleveland Clinic, Head and Neck Institute, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Yang FJ, Yeh LL, Wu CM. Prognostic Factors for Communication Improvement in Young Children After Cochlear Implant Surgery. Otol Neurotol 2021; 42:390-395. [PMID: 33278247 DOI: 10.1097/mao.0000000000002922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to examine the prognostic factors for post-cochlear implant (CI) communication improvement and determine whether the otologist's and speech-language pathologist's (SLP's) recommendations exhibited the same predictive performance regarding children's post-CI verbal expression acquisition. STUDY DESIGN Retrospective, diagnostic study. SETTING Hospital. PATIENTS The study reviewed 339 medical charts of preschool children who underwent CI surgery before the age of 6 years during 1999 to 2016. After these medical charts were assessed, the cohort comprised of 79 preschool children with pre- and post-CI surgery speech-language assessment reports and medical records. INTERVENTION A senior SLP and an otologist conducted blind testing of CI candidacy according to the 79 children's pre-CI reports. MAIN OUTCOME MEASURES Spoken mean length of utterance (MLU). RESULTS Children with superior skills in comprehending facial and gesture expressions or using gestures or sounds for expression were significantly more likely to receive the SLP's recommendation for CI surgery. The SLP's CI candidacy recommendation, based on background information, communication skill assessments, and magnetic resonance imaging (provided by an otologist), had significant predictive effects. Children recommended by the SLP exhibited a 20 times higher probability of benefiting from CI surgery; such a benefit would be a longer MLU after 2 years. CONCLUSION CI candidacy testing for young children with prelingual hearing impairment based on a SLP's recommendations provided significant predictive effects. LEVEL OF EVIDENCE 4 (Evidence from well-designed case-control or cohort studies).
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Affiliation(s)
- Fang-Jane Yang
- Department of Otolaryngology, Chang-Gung Memorial Hospital, Linkou, Taiwan
| | - Li-Li Yeh
- Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City, Taiwan
| | - Che-Ming Wu
- Department of Otolaryngology, Chang-Gung Memorial Hospital, Linkou, Taiwan
- Department of Otolaryngology, Chang-Gung Memorial Hospital, Chang-Gung University, Linkou, Taiwan
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Wang S, Wang Y, Li Y, Wei Y, Han F, Ren H, Xu Y, Cui Y. Cochlear implantation in children with white matter lesions: Prediction of hearing outcomes by multiple regression analysis. Medicine (Baltimore) 2021; 100:e23355. [PMID: 33429729 PMCID: PMC7793319 DOI: 10.1097/md.0000000000023355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/26/2020] [Indexed: 01/05/2023] Open
Abstract
Brain magnetic resonance imaging (MRI) white matter lesions have been reported in some preoperative cochlear implant children. However, the role of white matter lesions in predicting the hearing outcome is yet unclear. The present study investigated the outcomes of cochlear implantation (CI) in 40 children with white matter lesions.The data from children with white matter lesions were reviewed in this retrospective study. Based on brain MRI, the patients were divided into 3 groups: mild, moderate, and severe. The children were treated with unilateral CI and monitored for a follow-up period of at least 3 years. The main outcome measures were category of auditory performance (CAP) and speech intelligibility rating (SIR). MRI white matter lesions, age at implant, gender, physical impairment, and cognitive impairment were obtained from a research database to assess the correlation with long-term CAP and SIR outcome by multiple regression analysis.The data of children with white matter lesions were reviewed (18 females and 23 males). The mean age at implantation was 31.6 months. Strikingly, all children obtained better CAP and SIR scores. The age at implantation, brain white matters lesions on MRI, and cognitive and physical disabilities were associated with CAP and SIR scores. Multiple regression established a weak correlation between the degree of white matter lesions on brain MRI and long-term CAP and SIR, while cognitive impairment strongly accounted for long-term CAP and SIR outcome.The majority of the children with brain white matter lesions obtained a satisfactory postoperative effect. The cognitive impairment before CI is a major factor, and such factor should be considered.
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Affiliation(s)
- Sufang Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Yannan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Yongxin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanyan Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Fugen Han
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Hongbo Ren
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Ying Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
| | - Yanhong Cui
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhenzhou Children's Hospital, Zhengzhou
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Zeng X, Lin Z, Han X, Li J, Zhang P, Gou L, Xu J. Bilateral Hearing Loss and Unilateral Cochlear Ossification in a Patient With Chronic Myelogenous Leukemia. EAR, NOSE & THROAT JOURNAL 2020; 100:301S-303S. [PMID: 32970497 DOI: 10.1177/0145561320961073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bilateral sensorineural deafness and unilateral cochlear ossification have rarely been described in patients with chronic myeloid leukemia (CML). A 21-year-old man presented to a hospital with right-sided sudden hearing loss and tinnitus. He was diagnosed with CML. Five days later, sudden hearing loss appeared in the other ear. Abnormality of the right-sided inner ear structure was revealed by preoperative magnetic resonance imaging; honeycomb-like cochlear ossification was observed during cochlear implant surgery in the right ear. The patient's auditory performance exhibited significant improvement after bilateral cochlear implantation in our hospital. Hematological disorders must be considered in patients with sensorineural hearing loss. Cochlear implantation is feasible in patients with CML who exhibit sensorineural deafness, but cochlear ossification should be carefully evaluated by means of preoperative imaging examinations.
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Affiliation(s)
- Xianhai Zeng
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China
| | - Zengping Lin
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Xiaodong Han
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Juanjuan Li
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Peng Zhang
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China
| | - Lingshan Gou
- 557766Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Jian Xu
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China.,Shenzhen Longgang Institute of Stomatology, Longgang, Shenzhen, Guangdong, China
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Cochlear implantation in prelingually deaf children with white matter lesions. Eur Arch Otorhinolaryngol 2020; 278:323-329. [PMID: 32462235 DOI: 10.1007/s00405-020-06075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE White matter lesions (WMLs) are the most common central nervous system changes observed during cochlear implant evaluation. However, its clinical significance in cochlear implantation (CI) remains unclear. The purpose of this study is to explore the effects of WMLs on hearing and speech rehabilitation of prelingually deaf children after CI. METHODS The data of forty-five children with WMLs who received CI from 2011 to 2014 were retrospectively reviewed. All patients underwent magnetic resonance imaging examination preoperatively. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scales were used to evaluate changes in the auditory and speech abilities of the patients, and the Fazekas scale was adopted to assess the extent of WMLs. The degree of WMLs was divided into four grades (none, mild, moderate, severe). We assessed hearing and speech abilities at the following time points: 6, 12, 24, 36, 48 and 60-months post-operation. RESULTS No significant differences in CAP scores were observed between WMLs groups and the control group at 12 months post-CI (p = 0.099), but marked between-group differences were found at 6, 24, 48- and 60-months post-CI. (p < 0.05). Similarly, no significant differences in the SIR scores were observed at 6 months post-CI (p = 0.087), but marked between-group differences were found at 12, 24, 48- and 60- months post-CI. (p < 0.05). Analysis of stratified group results revealed improvements in hearing and speech development for all the subgroups, including the severe WMLs subgroup following CI. However, hearing and speech ability of the severe WMLs subgroup was much slower than that of other groups. CONCLUSIONS The auditory and speech abilities of prelingually deaf children with WMLs and those without WMLs can improve after CI. Therefore, WMLs should not be considered a contraindication for CI. However, the decision to perform CI in such patients needs a comprehensive evaluation because the post-surgery effects on children with severe WMLs are not ideal.
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Ratnanather JT. Structural neuroimaging of the altered brain stemming from pediatric and adolescent hearing loss-Scientific and clinical challenges. WILEY INTERDISCIPLINARY REVIEWS. SYSTEMS BIOLOGY AND MEDICINE 2020; 12:e1469. [PMID: 31802640 PMCID: PMC7307271 DOI: 10.1002/wsbm.1469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/01/2019] [Accepted: 10/13/2019] [Indexed: 12/20/2022]
Abstract
There has been a spurt in structural neuroimaging studies of the effect of hearing loss on the brain. Specifically, magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) technologies provide an opportunity to quantify changes in gray and white matter structures at the macroscopic scale. To date, there have been 32 MRI and 23 DTI studies that have analyzed structural differences accruing from pre- or peri-lingual pediatric hearing loss with congenital or early onset etiology and postlingual hearing loss in pre-to-late adolescence. Additionally, there have been 15 prospective clinical structural neuroimaging studies of children and adolescents being evaluated for cochlear implants. The results of the 70 studies are summarized in two figures and three tables. Plastic changes in the brain are seen to be multifocal rather than diffuse, that is, differences are consistent across regions implicated in the hearing, speech and language networks regardless of modes of communication and amplification. Structures in that play an important role in cognition are affected to a lesser extent. A limitation of these studies is the emphasis on volumetric measures and on homogeneous groups of subjects with hearing loss. It is suggested that additional measures of morphometry and connectivity could contribute to a greater understanding of the effect of hearing loss on the brain. Then an interpretation of the observed macroscopic structural differences is given. This is followed by discussion of how structural imaging can be combined with functional imaging to provide biomarkers for longitudinal tracking of amplification. This article is categorized under: Developmental Biology > Developmental Processes in Health and Disease Translational, Genomic, and Systems Medicine > Translational Medicine Laboratory Methods and Technologies > Imaging.
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Affiliation(s)
- J. Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, Maryland
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
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Zhang X, Weng Y, Liang M, Liu J, Chen Y, Zheng Y. Auditory and speech function after cochlear implantation in prelingually deaf children with white matter lesions. Dev Med Child Neurol 2019; 61:680-688. [PMID: 30556123 DOI: 10.1111/dmcn.14128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2018] [Indexed: 11/27/2022]
Abstract
AIM To explore how auditory and speech function developed post-cochlear implantation (pCI) in prelingually deaf children with white matter lesions (WML). METHOD Patients (41 males, 29 females; mean age at implantation 2y 11mo [SD 7.5mo], range 1y 8mo-5y) were divided into the following groups according to preoperative brain magnetic resonance imaging evaluation: mild WML, moderate WML, severe WML, and control. We assessed auditory and speech performance at baseline, 6 months, 12 months, and 24 months pCI. As well as auditory event-related potentials, topographic maps and electroencephalography source imaging were recorded and analysed at 24 months pCI. RESULTS For children with WML (any level), postoperative auditory or speech performance at 6 months was significantly below that of control participants. After stratification, auditory and speech performance was highly related to WML grading. Auditory or speech performance in mild WML or control groups was comparatively better than the moderate WML and severe WML groups. The recovery rate of speech performance fell behind that of the auditory perception. With the increasing severity of WML, N1 amplitude was significantly smaller with a consistent presentation in the topographic map, which was similar in the mild WML and control group. The dominant auditory centre was activated in the control or mild WML groups, but not in the moderate WML and severe WML groups. INTERPRETATION WML gradually affect auditory and speech development, and electrophysiological performance pCI in prelingually deaf children. WHAT THIS PAPER ADDS Auditory and speech performance in prelingually deaf children with white matter lesions (WML) was significantly worse than those without WML. Postoperative auditory and speech performance in children with WML was highly related to WML grading. Grand N1 amplitude in auditory event-related potentials was negatively related to the severity of WML. Non-dominant areas close to the auditory cortex were potentially activated in severe WML.
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Affiliation(s)
- Xueyuan Zhang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yinlun Weng
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Maojin Liang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiahao Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuebo Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Computed tomography versus magnetic resonance imaging in paediatric cochlear implant assessment: a pilot study and our experience at Great Ormond Street Hospital. The Journal of Laryngology & Otology 2018; 132:529-533. [PMID: 30019664 DOI: 10.1017/s0022215118000440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND To date, there is a lack of consensus regarding the use of both computed tomography and magnetic resonance imaging in the pre-operative assessment of cochlear implant candidates. METHODS Twenty-five patients underwent high-resolution computed tomography and magnetic resonance imaging. 'Control scores' describing the expected visualisation of specific features by computed tomography and magnetic resonance imaging were established. An independent radiological review of all computed tomography and magnetic resonance imaging scan features was then compared to the control scores and the findings recorded. RESULTS Agreement with control scores occurred in 83 per cent (20 out of 24) of computed tomography scans and 91 per cent (21 out of 23) of magnetic resonance imaging scans. Radiological abnormalities were demonstrated in 16 per cent of brain scans and 18 per cent of temporal bone investigations. CONCLUSION Assessment in the paediatric setting constitutes a special situation given the likelihood of congenital temporal bone abnormalities and associated co-morbidities that may be relevant to surgery and prognosis following cochlear implantation. Both computed tomography and magnetic resonance imaging contribute valuable information and remain necessary in paediatric cochlear implant pre-operative assessment.
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Takahashi M, Arai Y, Sakuma N, Yabuki K, Sano D, Nishimura G, Oridate N, Usami SI. Cochlear volume as a predictive factor for residual-hearing preservation after conventional cochlear implantation. Acta Otolaryngol 2018; 138:345-350. [PMID: 29148288 DOI: 10.1080/00016489.2017.1393840] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The preservation of residual hearing after conventional cochlear implantation (CI) is frequently observed when atraumatic soft surgery is adopted. The purpose of this study was to elucidate the predictive factors for residual hearing preservation after atraumatic CI. PATIENTS This study included 46 patients who underwent CI based on an atraumatic technique using a standard-length flexible electrode implant through a round window approach. MAIN OUTCOME MEASURE Cochlear volume was measured using magnetic resonance imaging (MRI). Cochlear duct length (CDL) was taken as the length of the scala media measured using computed tomography (CT). The association between residual hearing preservation and cochlear volume/CDL was then examined. RESULT Cochlear volume and CDL were significantly larger in patients with complete hearing preservation than in those with hearing loss. Multivariate logistic regression analysis revealed that cochlear volume was a significant predictive factor for residual hearing preservation. CONCLUSION Residual hearing preservation after conventional CI was observed in patients with a larger cochlear volume and longer CDL. Cochlear volume could be a predictive factor for residual hearing preservation after conventional CI.
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Affiliation(s)
- Masahiro Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yasuhiro Arai
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Naoko Sakuma
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kenichiro Yabuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Goshi Nishimura
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shin-ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Nagano, Japan
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Temporal High-Resolution Computed Tomography and Magnetic Resonance Imaging of Congenital Inner Ear Anomalies in Children. J Craniofac Surg 2016; 27:e632-e636. [PMID: 27513780 DOI: 10.1097/scs.0000000000002981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Imaging plays an important role in determining indications of cochlear implantation and choosing candidates for the procedure in children. Temporal high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) can display precisely the complex anatomic structure of inner ear. Although HRCT permits detailed imaging of bony structures, MRI gives valuable information about membranous labyrinth, internal acoustic canal, and vestibulocochlear nerve. Magnetic resonance imaging examination of the brain should be performed at the same time to evaluate any coexistent brain parenchymal abnormality. These imaging modalities are complementary methods in evaluating congenital inner ear anomalies. The aim of this pictorial essay is to reviewing temporal HRCT and MRI findings of congenital inner ear anomalies.
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Huang L, Zheng W, Wu C, Wei X, Wu X, Wang Y, Zheng H. Diffusion Tensor Imaging of the Auditory Neural Pathway for Clinical Outcome of Cochlear Implantation in Pediatric Congenital Sensorineural Hearing Loss Patients. PLoS One 2015; 10:e0140643. [PMID: 26485661 PMCID: PMC4618518 DOI: 10.1371/journal.pone.0140643] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 09/29/2015] [Indexed: 11/18/2022] Open
Abstract
Although conventional structural MRI provides vital information in the evaluation of congenital sensorineural hearing loss (SNHL), it is relatively insensitive to white matter microstructure. Our objective was to evaluate possible changes in microstructure of the auditory pathway in children with congenital sensorineural hearing loss (SNHL), and the possible distinction between good and poor outcome of cochlear implantation (CI) patients by using diffusion tensor imaging (DTI). Twenty-four patients with congenital SNHL and 20 healthy controls underwent conventional MRI and DTI examination using a 1.5T MR scanner. The DTI metrics of fractional anisotropy (FA) and mean diffusivity (MD) of six regions of interest (ROIs) positioned along the auditory pathway—the trapezoid body, superior olivary nucleus, inferior colliculus, medial geniculate body, auditory radiation and white matter of Heschl's gyrus—was measured in all subjects. Among the 24 patients, 8 patients with a categorie of auditory performance (CAP) score over 6 were classified into the good outcome group, and 16 patients with a CAP score below 6 were classified into the poor outcome group. A significant decrease was observed in FA values while MD values remained unchanged at the six ROIs of SNHL patients compared with healthy controls. Compared to good outcome subjects, poor outcome subjects displayed decreased FA values at all of the ROIs. No changes were observed in MD values. Correlation analyses only revealed strong correlations between FA values and CAP scores, and strong correlations between CAP scores and age at implant were also found. No correlations of FA values with age at implant were observed. Our results show that preoperative DTI can be used to evaluate microstructural alterations in the auditory pathway that are not detectable by conventional MR imaging, and may play an important role in evaluating the outcome of CI. Early cochlear implantation might be more effectively to restore hearing in SNHL patients.
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Affiliation(s)
- Lexing Huang
- Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Wenbin Zheng
- Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
- * E-mail:
| | - Chunxiao Wu
- Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Xiaoqin Wei
- Department of E.N.T, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Xianguang Wu
- Department of E.N.T, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yanting Wang
- Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Hongyi Zheng
- Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
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Incidence of Brain Abnormalities Detected on Preoperative Brain MR Imaging and Their Effect on the Outcome of Cochlear Implantation in Children with Sensorineural Hearing Loss. Int J Biomed Imaging 2015; 2015:275786. [PMID: 25685142 PMCID: PMC4320865 DOI: 10.1155/2015/275786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/28/2014] [Accepted: 12/28/2014] [Indexed: 12/04/2022] Open
Abstract
The incidence of sensorineural hearing loss (SNHL) increased gradually in the past decades. High-resolution computed tomography (HRCT) and magnetic resonance (MR) imaging, as an important part of preimplantation evaluation for children with SNHL, could provide the detailed information about the inner ear, the vestibulocochlear nerve, and the brain, so as to select suitable candidate for cochlear implantation (CI). Brain abnormalities were not rare in the brain MR imaging of SNHL children; however, its influence on the effect of CI has not been clarified. After retrospectively analyzing the CT and MR imaging of 157 children with SNHL that accepted preoperative evaluation from June 2011 to February 2013 in our hospital and following them during a period of 14.09 ± 5.08 months, we found that the white matter change, which might be associated with the history of medical condition, was the most common brain abnormality. Usually CI was still beneficial to the children with brain abnormalities, and the short-term hearing improvement could be achieved. Further study with more patients and longer follow-up time was needed to confirm our results.
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Wu C, Huang L, Tan H, Wang Y, Zheng H, Kong L, Zheng W. Diffusion tensor imaging and MR spectroscopy of microstructural alterations and metabolite concentration changes in the auditory neural pathway of pediatric congenital sensorineural hearing loss patients. Brain Res 2014; 1639:228-34. [PMID: 25536303 DOI: 10.1016/j.brainres.2014.12.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/29/2014] [Accepted: 12/09/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Our objective was to evaluate age-dependent changes in microstructure and metabolism in the auditory neural pathway, of children with profound sensorineural hearing loss (SNHL), and to differentiate between good and poor surgical outcome cochlear implantation (CI) patients by using diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). MATERIALS AND METHODS Ninety-two SNHL children (49 males, 43 females; mean age, 4.9 years) were studied by conventional MR imaging, DTI and MRS. Patients were divided into three groups: Group A consisted of children≤1 years old (n=20), Group B consisted of children 1-3 years old (n=31), and group C consisted of children 3-14 years old (n=41). Among the 31 patients (19 males and 12 females, 12m- 14y ) with CI, 18 patients (mean age 4.8±0.7 years) with a categories of auditory performance (CAP) score over five were classified into the good outcome group and 13 patients (mean age, 4.4±0.7 years) with a CAP score below five were classified into the poor outcome group. Two DTI parameters, fractional anisotropy (FA) and apparent diffusion coefficient (ADC), were measured in the superior temporal gyrus (STG) and auditory radiation. Regions of interest for metabolic change measurements were located inside the STG. DTI values were measured based on region-of-interest analysis and MRS values for correlation analysis with CAP scores. RESULTS Compared with healthy individuals, 92 SNHL patients displayed decreased FA values in the auditory radiation and STG (p<0.05). Only decreased FA values in the auditory radiation was observed in Group A. Decreased FA values in the auditory radiation and STG were both observed in B and C groups. However, in Group C, the N-acetyl aspartate/creatinine ratio in the STG was also significantly decreased (p<0.05). Correlation analyses at 12 months post-operation revealed strong correlations between the FA, in the auditory radiation, and CAP scores (r=0.793, p<0.01). CONCLUSIONS DTI and MRS can be used to evaluate microstructural alterations and metabolite concentration changes in the auditory neural pathway that are not detectable by conventional MR imaging. The observed changes in FA suggest that children with SNHL have a developmental delay in myelination in the auditory neural pathway, and it also display greater metabolite concentration changes in the auditory cortex in older children, suggest that early cochlear implantation might be more effective in restoring hearing in children with SNHL. This article is part of a Special Issue entitled SI: Brain and Memory.
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Affiliation(s)
- Chunxiao Wu
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Lexing Huang
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Hui Tan
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yanting Wang
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Hongyi Zheng
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Lingmei Kong
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Wenbin Zheng
- The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China.
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Kachniarz B, Chen JX, Gilani S, Shin JJ. Diagnostic yield of MRI for pediatric hearing loss: a systematic review. Otolaryngol Head Neck Surg 2014; 152:5-22. [PMID: 25389321 DOI: 10.1177/0194599814555837] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To perform a systematic review to analyze the diagnostic yield of magnetic resonance imaging (MRI) for pediatric hearing loss, including comparison to computed tomography (CT) and subgroup evaluation according to impairment severity and specific diagnostic findings (cochlear anomalies, enlarged vestibular aqueduct, cochlear nerve abnormalities, and brain findings). DATA SOURCES Pubmed, EMBASE, and the Cochrane library were assessed from their inception through December 2013. Manual searches were also performed, and topic experts were contacted. REVIEW METHODS Data from studies describing the use of MRI with or without comparison to CT in the diagnostic evaluation of pediatric patients with hearing loss were evaluated, according to a priori inclusion/exclusion criteria. Two independent evaluators corroborated the extracted data. Heterogeneity was evaluated according to the I(2) statistic. RESULTS There were 29 studies that evaluated 2434 patients with MRIs and 1451 patients with CTs that met inclusion/exclusion criteria. There was a wide range of diagnostic yield from MRI. Heterogeneity among studies was substantial but improved with subgroup analysis. Meta-analysis of yield differences demonstrated that CT had a greater yield than MRI for enlarged vestibular aqueduct (yield difference 16.7% [95% CI, 9.1%-24.4%]) and a borderline advantage for cochlear anomalies (4.7% [95% CI, 0.1%-9.5%]). Studies were more likely to report brain findings with MRI. CONCLUSIONS These data may be utilized in concert with that from studies of risks of MRI and risk/yield of CT to inform the choice of diagnostic testing.
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Affiliation(s)
| | - Jenny X Chen
- Harvard Medical School, Boston, Massachusetts, USA
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Vaid S, Vaid N. Imaging for cochlear implantation: Structuring a clinically relevant report. Clin Radiol 2014; 69:e9-e24. [DOI: 10.1016/j.crad.2014.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/19/2014] [Accepted: 03/13/2014] [Indexed: 11/25/2022]
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Tan L, Chen Y, Maloney TC, Caré MM, Holland SK, Lu LJ. Combined analysis of sMRI and fMRI imaging data provides accurate disease markers for hearing impairment. NEUROIMAGE-CLINICAL 2013; 3:416-28. [PMID: 24363991 PMCID: PMC3863984 DOI: 10.1016/j.nicl.2013.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 11/15/2022]
Abstract
In this research, we developed a robust two-layer classifier that can accurately classify normal hearing (NH) from hearing impaired (HI) infants with congenital sensori-neural hearing loss (SNHL) based on their Magnetic Resonance (MR) images. Unlike traditional methods that examine the intensity of each single voxel, we extracted high-level features to characterize the structural MR images (sMRI) and functional MR images (fMRI). The Scale Invariant Feature Transform (SIFT) algorithm was employed to detect and describe the local features in sMRI. For fMRI, we constructed contrast maps and detected the most activated/de-activated regions in each individual. Based on those salient regions occurring across individuals, the bag-of-words strategy was introduced to vectorize the contrast maps. We then used a two-layer model to integrate these two types of features together. With the leave-one-out cross-validation approach, this integrated model achieved an AUC score of 0.90. Additionally, our algorithm highlighted several important brain regions that differentiated between NH and HI children. Some of these regions, e.g. planum temporale and angular gyrus, were well known auditory and visual language association regions. Others, e.g. the anterior cingulate cortex (ACC), were not necessarily expected to play a role in differentiating HI from NH children and provided a new understanding of brain function and of the disorder itself. These important brain regions provided clues about neuroimaging markers that may be relevant to the future use of functional neuroimaging to guide predictions about speech and language outcomes in HI infants who receive a cochlear implant. This type of prognostic information could be extremely useful and is currently not available to clinicians by any other means. We probe brain structural and functional changes in hearing impaired (HI) infants. We build a robust two-layer classifier that integrates sMRI and fMRI data. This integrated model accurately separates HI from normal infants (AUC 0.9). Our method detects important brain regions different between HI and normal infants. Our method can include diverse types of data and be applied to other diseases.
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Affiliation(s)
- Lirong Tan
- Division of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA
- School of Computing Sciences and Informatics, University of Cincinnati, 810 Old Chemistry, Cincinnati, OH 45221-0008, USA
| | - Ye Chen
- Division of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA
- School of Electronics and Computing Systems, University of Cincinnati, 497 Rhodes Hall, Cincinnati, OH 45221, USA
| | - Thomas C. Maloney
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45221, USA
| | - Marguerite M. Caré
- Department of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45221, USA
| | - Scott K. Holland
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45221, USA
- Department of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45221, USA
| | - Long J. Lu
- Division of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA
- School of Computing Sciences and Informatics, University of Cincinnati, 810 Old Chemistry, Cincinnati, OH 45221-0008, USA
- Department of Environmental Health, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0524, USA
- Corresponding author at: Division of Biomedical Informatics, MLC 7024, Cincinnati Children's Hospital Research Foundation, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Tel.: + 1 513 636 8720; fax: + 1 513 636 2056. http://dragon.cchmc.org
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