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Langner S, Weiss NM. [Congenital malformations of the inner ear - CT, DVT and MR Imaging]. Laryngorhinootologie 2024; 103:668-681. [PMID: 39222633 DOI: 10.1055/a-2339-9811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
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2
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D'Arco F, Kandemirli SG, Dahmoush HM, Alves CAPF, Severino M, Dellepiane F, Robson CD, Lequin MH, Rossi-Espagnet C, O'Brien WT, Nash R, Clement E, Juliano AF. Incomplete partition type II in its various manifestations: isolated, in association with EVA, syndromic, and beyond; a multicentre international study. Neuroradiology 2024; 66:1397-1403. [PMID: 38833161 DOI: 10.1007/s00234-024-03386-z] [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] [Received: 02/12/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Incomplete partition type II (IP-II) is characterized by specific histological features and radiological appearance. It may occur in isolation or in association with an enlarged vestibular aqueduct (EVA). Among those with IP-II and EVA, a subset has a diagnosis of Pendred syndrome. This study aimed to explore the prevalence of isolated IP-II, IP-II with EVA, and cases with a genetic or syndromic basis in our cohort. METHODS From a large, multicentre database of dysplastic cochleae (446 patients, 892 temporal bones), those with imaging features of IP-II were examined in detail, including whether there was a genetic or syndromic association. RESULTS A total of 78 patients with IP-II were identified. Among these, 55 patients had bilateral IP-II and EVA (only 12 with typical Mondini triad), 8 with bilateral IP-II and normal VA, 2 with bilateral IP-II and unilateral EVA, and 13 with unilateral IP-II (9 with unilateral EVA). Among the group with bilateral IP-II and bilateral EVA in whom genetic analysis was available, 14 out of 29 (48%) had SLC26A4 mutations and a diagnosis of Pendred syndrome, 1 had a FOXI1 mutation, and a few other genetic abnormalities; none had KCNJ10 pathogenic variants. CONCLUSION Bilateral IP-II-bilateral EVA may be seen in the context of Pendred syndrome (SLC26A4 or FOXI1 mutations) but, in the majority of our cohort, no genetic abnormalities were found, suggesting the possibility of unknown genetic associations. IP-II in isolation (without EVA) is favored to be genetic when bilateral, although the cause is often unknown.
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Affiliation(s)
- Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Sedat G Kandemirli
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Hisham M Dahmoush
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, USA
| | - Cesar A P F Alves
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | | | | | - Caroline D Robson
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Maarten H Lequin
- Department of Radiology, Texas Children's Hospital, North Campus, Austin, TX, USA
| | - Camilla Rossi-Espagnet
- Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital, IRCCS , Rome, Italy
| | - William T O'Brien
- Department of Radiology, Orlando Health - Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Robert Nash
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - Emma Clement
- Department of Clinical Genetics, Great Ormond Street Hospital for Children, London, UK
| | - Amy F Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles St, 02114, Boston, MA, USA.
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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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D'Arco F, Mertiri L, de Graaf P, De Foer B, Popovič KS, Argyropoulou MI, Mankad K, Brisse HJ, Juliano A, Severino M, Van Cauter S, Ho ML, Robson CD, Siddiqui A, Connor S, Bisdas S. Guidelines for magnetic resonance imaging in pediatric head and neck pathologies: a multicentre international consensus paper. Neuroradiology 2022; 64:1081-1100. [PMID: 35460348 DOI: 10.1007/s00234-022-02950-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/05/2022] [Indexed: 12/19/2022]
Abstract
The use of standardized imaging protocols is paramount in order to facilitate comparable, reproducible images and, consequently, to optimize patient care. Standardized MR protocols are lacking when studying head and neck pathologies in the pediatric population. We propose an international, multicenter consensus paper focused on providing the best combination of acquisition time/technical requirements and image quality. Distinct protocols for different regions of the head and neck and, in some cases, for specific pathologies or clinical indications are recommended. This white paper is endorsed by several international scientific societies and it is the result of discussion, in consensus, among experts in pediatric head and neck imaging.
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Affiliation(s)
- Felice D'Arco
- Radiology Department, Great Ormond Street Hospital for Children, London, UK.,Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Livja Mertiri
- Radiology Department, Great Ormond Street Hospital for Children, London, UK. .,Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy.
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bert De Foer
- Radiology Department, GZA Hospitals, Antwerp, Belgium
| | - Katarina S Popovič
- Neuroradiology Department, Clinical Institute of Radiology, University Medical Center Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia
| | - Maria I Argyropoulou
- Department of Clinical Radiology and Imaging, Medical School, University of Ioannina, Ioannina, Greece
| | - Kshitij Mankad
- Radiology Department, Great Ormond Street Hospital for Children, London, UK
| | - Hervé J Brisse
- Imaging Department, Institut Curie, Paris, France.,Institut Curie, Paris Sciences Et Lettres (PSL) Research University, Paris, France
| | - Amy Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | | | - Sofie Van Cauter
- Department of Medical Imaging, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Mai-Lan Ho
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ata Siddiqui
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Steve Connor
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK.,School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College, London, UK
| | - Sotirios Bisdas
- Lysholm Department of Neuroradiology, The National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, 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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Brotto D, Sorrentino F, Cenedese R, Avato I, Bovo R, Trevisi P, Manara R. Genetics of Inner Ear Malformations: A Review. Audiol Res 2021; 11:524-536. [PMID: 34698066 PMCID: PMC8544219 DOI: 10.3390/audiolres11040047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
Inner ear malformations are present in 20% of patients with sensorineural hearing loss. Although the first descriptions date to the 18th century, in recent years the knowledge about these conditions has experienced terrific improvement. Currently, most of these conditions have a rehabilitative option. Much less is known about the etiology of these anomalies. In particular, the evolution of genetics has provided new data about the possible relationship between inner ear malformations and genetic anomalies. In addition, in syndromic condition, the well-known presence of sensorineural hearing loss can now be attributed to the presence of an inner ear anomaly. In some cases, the presence of these abnormalities should be considered as a characteristic feature of the syndrome. The present paper aims to summarize the available knowledge about the possible relationships between inner ear malformations and genetic mutations.
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Affiliation(s)
- Davide Brotto
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
- Correspondence:
| | - Flavia Sorrentino
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Roberta Cenedese
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Irene Avato
- Department of Diagnostic, Paediatric, Clinical and Surgical Science, University of Pavia, 35128 Pavia, Italy;
| | - Roberto Bovo
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Patrizia Trevisi
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Renzo Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padua, 35128 Padua, Italy;
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8
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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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Talenti G, Robson C, Severino MS, Alves CA, Chitayat D, Dahmoush H, Smith L, Muntoni F, Blaser SI, D'Arco F. Characteristic Cochlear Hypoplasia in Patients with Walker-Warburg Syndrome: A Radiologic Study of the Inner Ear in α-Dystroglycan-Related Muscular Disorders. AJNR Am J Neuroradiol 2021; 42:167-172. [PMID: 33122211 PMCID: PMC7814787 DOI: 10.3174/ajnr.a6858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Walker-Warburg syndrome, muscle-eye-brain disease, and Fukuyama congenital muscular dystrophy are α-dystroglycan-related muscular disorders associated with brain malformations and eye abnormalities in which no structural inner ear abnormality has been described radiologically. We collected patients from 6 tertiary pediatric hospitals and reported the radiologic features and frequency of inner ear dysplasias. MATERIALS AND METHODS Patients previously diagnosed clinicoradiologically with Walker-Warburg syndrome, muscle-eye-brain disease, or Fukuyama congenital muscular dystrophy were included. We recorded the pathogenic variant, when available. Brain MR imaging and/or CT findings were reviewed in consensus, and inner ear anomalies were classified according to previous description in the literature. We then correlated the clinicoradiologic phenotype with the inner ear phenotype. RESULTS Thirteen patients fulfilled the criteria for the Walker-Warburg syndrome phenotype, 8 for muscle-eye-brain disease, and 3 for Fukuyama congenital muscular dystrophy. A dysplastic cochlea was demonstrated in 17/24. The most frequent finding was a pronounced cochlear hypoplasia type 4 with a very small anteriorly offset turn beyond the normal-appearing basal turn (12/13 patients with Walker-Warburg syndrome and 1/11 with muscle-eye-brain disease or Fukuyama congenital muscular dystophy). Two of 8 patients with muscle-eye-brain disease, 1/3 with Fukuyama congenital muscular dystrophy, and 1/13 with Walker-Warburg syndrome showed a less severe cochlear hypoplasia type 4. The remaining patients without Walker-Warburg syndrome were healthy. The vestibule and lateral semicircular canals of all patients were normal. Cranial nerve VIII was present in all patients with diagnostic MR imaging. CONCLUSIONS Most patients with the severe α-dystroglycanopathy Walker-Warburg syndrome phenotype have a highly characteristic cochlear hypoplasia type 4. Patients with the milder variants, muscle-eye-brain disease and Fukuyama congenital muscular dystrophy, more frequently have a normal cochlea or milder forms of hypoplasia.
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Affiliation(s)
- G Talenti
- From the Department of Diagnostics and Pathology (G.T.), Neuroradiology Unit, Verona University Hospital, Verona, Italy
| | - C Robson
- Division of Neuroradiology (C.R.), Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - M S Severino
- Neuroradiology Unit (M.S.S.), Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Giannina Gaslini, Genova, Italy
| | - C A Alves
- Departments of Radiology and Division of Neuroradiology (C.A.A.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - D Chitayat
- The Prenatal Diagnosis and Medical Genetics Program (D.C.), Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - H Dahmoush
- Department of Radiology (H.D.), Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California
| | - L Smith
- Dental and Maxillofacial Surgery Department (L.S.), Great Ormond Street Hospital, London, UK
| | - F Muntoni
- Dubowitz Neuromuscular Centre (F.M.), UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - S I Blaser
- Division of Neuroradiology (S.I.B.), Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - F D'Arco
- Neuroradiology Unit (F.D.), Department of Radiology, Great Ormond Street Hospital for Children, National Health Service Trust, London, UK felice.d'
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Ng MMY, D'Arco F, Chorbachi R, Nash R. Oval window perilymph fistula in child with recurrent meningitis and unilateral hearing loss. BMJ Case Rep 2020; 13:13/7/e234744. [PMID: 32713834 DOI: 10.1136/bcr-2020-234744] [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: 11/04/2022] Open
Abstract
A 2-year-old boy presented to Ears, Nose and Throat (ENT) surgeons with unilateral hearing loss. Following a prodrome of upper respiratory tract infection (URTI), he developed two episodes of pneumococcal meningitis in quick succession. This case demonstrates an unusual cause of perilymph fistula diagnosed on imaging and confirmed surgically. He had failed the Newborn Hearing Screening Programme and was therefore referred to audiology, who confirmed profound sensorineural hearing loss in the right ear. MRI showed incomplete partitioning (type 1) of the right cochlea, suggesting cerebrospinal fluid (CSF) leak from the region of the stapes. Exploratory tympanotomy confirmed this, and proceeded to CSF leak repair, obliteration of the Eustachian tube, subtotal petrosectomy, abdominal fat grafting and blind sac closure. Although middle ear effusions are common; particularly in children with recent URTI, the possibility of otogenic CSF leak needs to be considered, especially in cases of recurrent meningitis.
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Affiliation(s)
- Miane Min Yan Ng
- Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Felice D'Arco
- Department of Radiology, NIHR GOSH BRC, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Raouf Chorbachi
- Department of Audiological Medicine/Audiology/Cochlear Implants, North Thames Cleft Service, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Robert Nash
- Department of Paediatric Otolaryngology, Cochlear Implants, Great Ormond Street Hospital for Children NHS Trust, London, UK.,University College London, London, UK
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11
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D'Arco F, Sanverdi E, O'Brien WT, Taranath A, Talenti G, Blaser SI. The link between inner ear malformations and the rest of the body: what we know so far about genetic, imaging and histology. Neuroradiology 2020; 62:539-544. [PMID: 32125475 DOI: 10.1007/s00234-020-02382-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
| | - Eser Sanverdi
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - William T O'Brien
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Ajay Taranath
- Department of Radiology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Giacomo Talenti
- Department of Diagnostics and Pathology, Neuroradiology Unit, Verona University Hospital, Verona, Italy
| | - Susan I Blaser
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
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12
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Eisenhut F, Taha L, Kleibe I, Hornung J, Iro H, Doerfler A, Lang S. Fusion of Preoperative MRI and Postoperative FD-CT for Direct Evaluation of Cochlear Implants : An Analysis at 1.5 T and 3 T. Clin Neuroradiol 2019; 30:729-737. [PMID: 31754757 DOI: 10.1007/s00062-019-00853-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/27/2019] [Indexed: 11/24/2022]
Abstract
AIM This study was carried out to evaluate the diagnostic value of merging preoperative magnetic resonance imaging (MRI) with postoperative flat-panel computed tomography (FD-CT) and compare it to standard postoperative FD-CT for assessment of cochlear implant (CI) insertion. METHODS The T2-weighted (T2w) constructive interference in steady state (CISS) data sets of preoperative 1.5 T and 3 T MRI scans of CI patients with both regular and adverse implant spiralization were co-registered with the corresponding postoperative FD-CT data sets using defined anatomic landmarks. These merged FD-CT/MRI volumes (CMV) were compared to the corresponding postoperative FD-CT MPRs in consensus reading with respect to qualitative, i.e. scala tympani spiralization, scala vestibuli spiralization, scalar translocation and quantitative, i.e. distance of the last electrode to the lateral cochlea wall (D1) distance of the 2nd/5th electrode to the basal cochlear wall (D2) and the transition point (TP) of the scalar translocation, parameters. RESULTS In total 30 patients (n 1.5T MRI = 18 patients; n 3T MRI = 12 patients) were included in the analysis. In all cases both CMVs and FD-CT MPRs were generated. Qualitative analysis of intracochlear CI position with CMVs (both 1.5 T and 3 T) and FD-CT was equivalent: In 20 patients the CI showed a regular implant spiralization, in 10 cases a scalar translocation was identified with both CMVs and FD-CT. Quantitative analysis showed a high level of congruency between CMVs (both 1.5 T and 3T) and FD-CT for fusion accuracy (D1: mean FD-CT D1 = 1.30 ± 0.7 mm; mean CMV D1 = 1.27 ± 0.77 mm, correlation r = 0.94, p < 0.0001; D2: mean FD-CT D2 = 1.17 ± 0.34 mm; mean CMV D2 = 1.10 ± 0.31 mm, correlation r = 0.89, p < 0.0001) and TP of the scalar translocation (mean FD-CT = 126.0 ± 59.25°, mean CMV = 117.0 ± 52.82°, correlation r = 0.95, p < 0.0001). CONCLUSION The co-registration of preoperative 1.5 and 3 T MRI with postoperative FD-CT enables a direct evaluation of the position of a CI equivalent to the current standard FD-CT. Despite the fact that CMV provided no additional diagnostic value in this series, regardless whether preoperative 1.5 or 3 T MRI was used for co-registration, it might help to simplify postoperative CI diagnostics.
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Affiliation(s)
- Felix Eisenhut
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Isabella Kleibe
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Joachim Hornung
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Stefan Lang
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
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Brotto D, Uberti A, Manara R. From Mondini to the latest inner ear malformations’ classifications: an historical and critical review. HEARING, BALANCE AND COMMUNICATION 2019. [DOI: 10.1080/21695717.2019.1663041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Davide Brotto
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
| | - Andrea Uberti
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
| | - Renzo Manara
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
- Department of Neuroradiology, Università Degli Studi di Padova, Padova, Italy
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Quirk B, Youssef A, Ganau M, D'Arco F. Radiological diagnosis of the inner ear malformations in children with sensorineural hearing loss. BJR Open 2019; 1:20180050. [PMID: 33178934 PMCID: PMC7592472 DOI: 10.1259/bjro.20180050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 11/24/2022] Open
Abstract
Malformations in either the inner ear, vestibulocochlear nerve (VIIIth) or auditory cortex of the brain can lead to congenital sensorineural hearing loss (SNHL). In most cases the underlying disorders involve the membranous labyrinth at a microscopic level and therefore radiological examinations are entirely normal. In a significant proportion however (up to 20%), there are abnormalities visualized in the inner ear and/or the VIIIth nerve; the type of abnormality is relevant for the surgical planning of a cochlear implant. Imaging and the accurate radiological identification of the affected inner ear structures therefore plays an integral role in the clinical evaluation of sensorineural hearing loss. In this pictorial review, we describe the main malformations of the inner ear in view of recent classifications and briefly explore the surgical implications.
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Affiliation(s)
- Bernadine Quirk
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Adam Youssef
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Mario Ganau
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust
| | - Felice D'Arco
- Great Ormond Street Hospital for Children NHS Foundation Trust
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Siddiqui A, D'Amico A, Colafati GS, Cicala D, Talenti G, Rajput K, Pinelli L, D'Arco F. Hypothalamic malformations in patients with X-linked deafness and incomplete partition type 3. Neuroradiology 2019; 61:949-952. [PMID: 31177298 DOI: 10.1007/s00234-019-02230-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
Patients with X-linked deafness carry mutations in the POU3F4 gene and have pathognomonic inner ear malformations characterised by symmetrical incomplete partition type 3 (absent modiolus and lamina spiralis but preserved interscalar septum in a normal-sized cochlea) and large internal auditory meatus (IAM) with an increased risk of gusher during stapes surgery. We describe a range of fairly characteristic malformations in the hypothalamus of some patients with this rare condition, ranging from subtle asymmetric appearance and thickening of the tuber cinereum to more marked hypothalamic enlargement. We discuss the role of POU3F4 in the normal development of both the inner ear and hypothalamus and the proposed pathophysiology of incomplete partition type 3.
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Affiliation(s)
- Ata Siddiqui
- Department of Neuroradiology, King's College Hospital, London, UK
| | - Alessandra D'Amico
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giovanna Stefania Colafati
- Oncological Neuroradiology Unit, Department of Imaging, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Domenico Cicala
- Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Giacomo Talenti
- Neuroradiology Unit, Verona University Hospital, Verona, Italy
| | - Kaukab Rajput
- Cochlear Implant Department, Great Ormond Street Hospital, London, UK
| | - Lorenzo Pinelli
- Neuroradiology Unit, Pediatric Neuroradiology Section, ASST Spedali Civili, Brescia, Italy
| | - Felice D'Arco
- Radiology Department, Great Ormond Street Hospital, Great Ormond St, London, WC1N3JH, UK.
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