Diagnostic Yield of Computed Tomography Scan for Pediatric Hearing Loss

Background Computed tomography (CT) has been used in the assessment of pediatric hearing loss, but concern regarding radiation risk and increased utilization of magnetic resonance imaging (MRI) have prompted us toward a more quantitative and sophisticated understanding of CT’s potential diagnostic yield. Objective To perform a systematic review to analyze the diagnostic yield of CT for pediatric hearing loss, including subgroup evaluation according to impairment severity and laterality, as well as the specific findings of enlarged vestibular aqueduct and narrow cochlear nerve canal. Data Sources PubMed, EMBASE, and the Cochrane Library were assessed from the date of their inception to December 2013. In addition, manual searches of bibliographies were performed and topic experts were contacted. Review Methods Data from studies describing the use of CT in the diagnostic evaluation of pediatric patients with hearing loss of unknown etiology were evaluated, according to a priori inclusion/exclusion criteria. Two independent evaluators corroborated the extracted data. Heterogeneity was evaluated according to the I2 statistic. Results In 50 criteria-meeting studies, the overall diagnostic yield of CT ranged from 7% to 74%, with the strongest and aggregate data demonstrating a point estimate of 30%. This estimate corresponded to a number needed to image of 4 (range, 2-15). The most commonly identified findings were enlarged vestibular aqueduct and cochlear anomalies. The largest studies showed a 4% to 7% yield for narrow cochlear nerve canal. Conclusion These data, along with similar analyses of radiation risk and risks/benefits of sedated MRI, may be used to help guide the choice of diagnostic imaging.

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Two siblings with progressive, fluctuating hearing loss after head trauma, treated with cochlear implantation

The Journal of Laryngology & Otology ◽

10.1017/s0022215109990296 ◽

2009 ◽

Vol 124 (1) ◽

pp. 86-89 ◽

Cited By ~ 6

Author(s):

M J F de Wolf ◽

J Honings ◽

F B M Joosten ◽

L Hoefsloot ◽

E A M Mylanus ◽

...

Keyword(s):

Computed Tomography ◽

Hearing Loss ◽

Case Report ◽

Cochlear Implant ◽

Head Trauma ◽

Cochlear Implantation ◽

Progressive Hearing Loss ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct ◽

Fluctuating Hearing Loss

AbstractObjective:Description of two siblings with unexplained, progressive, perceptive hearing loss after head trauma.Design:Case report.Subjects:Two siblings aged six and eight years old with bilateral, intermittent but progressive hearing loss.Results:These patients had a c.1172G>A (p.Ser391Asn) mutation in the SLC26A4 gene, which has not previously been reported and which caused Pendred or enlarged vestibular aqueduct syndrome. The diagnosis was based on the perceptive hearing loss, computed tomography findings and mutation analysis. The patients were each fitted with a cochlear implant because of their severe, progressive, perceptive hearing loss with deep fluctuations. The results were good.Conclusion:Further testing for the presence of an enlarged vestibular aqueduct is recommended when children present with sudden progression in perceptive hearing loss, whether or not in combination with head trauma. Cochlear implantation is indicated in patients with persistent, progressive hearing loss that leads to deafness. Implantation can be undertaken successfully despite cochlear hypoplasia.

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Role of Computed Tomography and Magnetic Resonance Imaging in detecting the Prevalence of inner ear anomalies among cochlear implant candidates

QJM ◽

10.1093/qjmed/hcab106.007 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Alaa Nasser Hussain Zaher ◽

Tougan Taha Abd El Aziz ◽

Ahmed Samy Abdelrahman

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Hearing Loss ◽

Cochlear Implant ◽

Inner Ear ◽

Resonance Imaging ◽

High Resolution Computed Tomography ◽

Vestibular Aqueduct ◽

Incomplete Partition ◽

Ear Anomalies

Abstract Background Hearing loss management using cochlear implants in patients with inner ear anomalies has long been discussed in the otology community. Magnetic resonances imaging (B,/IRI) and Computed tomography (CT) play important roles in the preoperative assessment of inner ear abnormalities such as cochlear nerve deficiency and variant anatomy as these abnormalities may not only affect the decision of the implantation procedure or the patient's prognosis regarding auditory improvement, but also the risk of complications. Objective To examine the prevalence of inner ear anomalies among cochlear implant recipients in patients with congenital sensorineural hearing loss among the pediatric age group in the Demerdash hospital, Ain Shams university using High resolution computed tomography (HRCT) and MRI imaging. Methods A retrospective descriptive study over the course of 9 months that included all patients that are candidates for cochlear implant referred to the Radiology department, Ain Shams University Hospitals for a preoperative imaging in the form of CT and VIRI scans. Results CT and MRI scans of 33 patients who had congenital hearing loss and were candidates for cochlear implantation with total 66 ears were reviewed. Inner ear anomalies were identified in 8 patients representing a prevalence (24.2%) with 14 ear diseased. Anomalies were seen bilaterally in 6 patients and unilaterally in 2 patients. Among the 14 diseased ear, 9 ears (64.3%) were seen with incomplete partition Il, 7 ears (50%) were seen with enlarged vestibular aqueduct, 4 ears (28.6%) were seen with cochlear hypoplasia, 3 ears (21.4%) were seen with semicircular canal aplasia, 2 ears (14.3%) were seen with incomplete partition type I, 2 ears (14.3%) were seen with cochlear nerve aplasia, 2 ears with cochlear aplasia (14.3%), I ear (7.1%) was seen with common cavity ear (7.1%) with complete labyrinthine aplasia. Conclusion Prevalence of inner ear anomalies among cochlear implant candidates was 24.2%. This result is consistent with results worldwide and the most common anomalies were Incomplete partition Il and large vestibular aqueduct. Abbreviations Computed tomography (CT), Magnetic resonance imaging (MRI), High resolution computed tomography (HRCT), Internal auditory canal (IAC), Cerebellopontine angle (CPA).

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Radiographic Measurement of Cochlear in Sudanese Population using High Resolution Computed Tomography (HRCT)

Pertanika Journal of Science and Technology ◽

10.47836/pjst.29.2.32 ◽

2021 ◽

Vol 29 (2) ◽

Author(s):

Lubna Bushara ◽

Mohamed Yousef ◽

Ikhlas Abdelaziz ◽

Mogahid Zidan ◽

Dalia Bilal ◽

...

Keyword(s):

Computed Tomography ◽

Hearing Loss ◽

High Resolution ◽

Temporal Bone ◽

Healthy Subjects ◽

Cochlear Nerve ◽

High Resolution Computed Tomography ◽

Mean Width ◽

The Mean ◽

The Right

This study aimed to determine the measurements of the cochlea among healthy subjects and hearing deafness subjects using a High Resolution Computed Tomography (HRCT). A total of 230 temporal bone HRCT cases were retrospectively investigated in the period spanning from 2011 to 2015. Three 64-slice units were used to examine patients with clinical complaints of hearing loss conditions at three Radiology departments in Khartoum, Sudan. For the control group (A) healthy subjects, the mean width of the right and left cochlear were 5.61±0.40 mm and 5.56±0.58 mm, the height were 3.56±0.36 mm and 3.54±0.36 mm, the basal turn width were 1.87±0.19 mm and 1.88 ±0.18 mm, the width of the cochlear nerve canal were 2.02±1.23 and 1.93±0.20, cochlear nerve density was 279.41±159.02 and 306.84±336.9 HU respectively. However, for the experimental group (B), the mean width of the right and left cochlear width were 5.38±0.46 mm and 5.34±0.30 mm, the height were 3.53±0.25 mm and 3.49±0.28mm, the basal turn width were 1.76±0.13 mm, and 1.79±0.13 mm, the width of the cochlear nerve canal were 1.75±0.18mm and 1.73±0.18mm, and cochlear nerve density were 232.84±316.82 and 196.58±230.05 HU, respectively. The study found there was a significant difference in cochlea’s measurement between the two groups with a p-value < 0.05. This study had established baseline measurements for the cochlear for the healthy Sudanese population. Furthermore, it found that HRCT of the temporal bone was the best for investigation of the cochlear and could provide a guide for the clinicians to manage congenital hearing loss.

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Enlarged Vestibular Aqueduct in Pediatric SNHL

Otolaryngology ◽

10.1016/j.otohns.2008.05.533 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P104-P104

Author(s):

Karuna Dewan ◽

Judith C. Lieu

Keyword(s):

Hearing Loss ◽

Cochlear Implant ◽

Sensorineural Hearing Loss ◽

Temporal Bone ◽

Pediatric Population ◽

Sensorineural Hearing ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct ◽

Current Estimation ◽

Temporal Bone Ct

Problem Current diagnostic criteria for enlarged vestibular aqueduct (EVA), >1.5mm at the midpoint, was determined in the pre-CT era by Valvassori. Recent research, based on 73 CTs from children with no sensorineural hearing loss (SNHL), suggests new criteria for the diagnosis of EVA—midpoint of >0.9mm or operculum >1.9mm. We evaluated the proposed new radiographic, Cincinnati criteria for the diagnosis of EVA. Methods In a retrospective cohort study, we reviewed temporal bone CT scans of 130 pediatric cochlear implant recipients to measure the vestibular aqueduct midpoint and opercular width and 5 other temporal bone dimensions. Results The Cincinnati criteria identified 44% of patients with EVA versus 16% with the Valvassori criterion (P < 0.01). Of those with EVA, 45% were unilateral and 55% were bilateral using Cincinnati criteria; 64% were unilateral and 36% bilateral using Valvassori criterion (P<0.01). Right and left side measurements of vestibular aqueduct operculum (r=0.67, P<0.01) and midpoint (r=0.58, P<0.01) correlated substantially. The Cincinnati criteria diagnosed 70 ears with EVA classified as normal using the Valvassori criterion (P<0.01). Of these 70 ears, 59 had no other medical explanation for their hearing loss. Conclusion The Cincinnati criteria identified a large percentage of pediatric cochlear implant patients with EVA who otherwise had no known etiology for their deafness. Significant correlations between right and left side measurements suggest that EVA may not be morphologically asymmetric as previously thought. Significance The Cincinnati criteria potentially alters the current estimation of the most common etiologies of bilateral severe-to-profound sensorineural hearing loss in the pediatric population. Support KD is a Doris Duke Clinical Research Fellow, supported by the Doris Duke Foundation.

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Subgroups of enlarged vestibular aqueduct in relation toSLC26A4mutations and hearing loss

The Laryngoscope ◽

10.1002/lary.24368 ◽

2013 ◽

Vol 124 (4) ◽

pp. E134-E140 ◽

Cited By ~ 17

Author(s):

Yasuhide Okamoto ◽

Hideki Mutai ◽

Atsuko Nakano ◽

Yukiko Arimoto ◽

Tomoko Sugiuchi ◽

...

Keyword(s):

Hearing Loss ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct

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Vestibular Aqueduct Midpoint Width and Hearing Loss in Patients With an Enlarged Vestibular Aqueduct

JAMA Otolaryngology–Head & Neck Surgery ◽

10.1001/jamaoto.2016.4522 ◽

2017 ◽

Vol 143 (6) ◽

pp. 601 ◽

Cited By ~ 7

Author(s):

Mustafa S. Ascha ◽

Nauman Manzoor ◽

Amit Gupta ◽

Maroun Semaan ◽

Cliff Megerian ◽

...

Keyword(s):

Hearing Loss ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct

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Hearing Loss in Enlarged Vestibular Aqueduct

Otology & Neurotology ◽

10.1097/mao.0000000000002843 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Haroon Shakeel Saeed ◽

Jonny Kenth ◽

Graeme Black ◽

Shakeel R. Saeed ◽

Stavros Stivaros ◽

...

Keyword(s):

Hearing Loss ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct

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Progressive Fluctuant Hearing Loss, Enlarged Vestibular Aqueduct, and Cochlear Hypoplasia in Branchio-oto-renal Syndrome

Otology & Neurotology ◽

10.1097/00129492-200109000-00014 ◽

2001 ◽

Vol 22 (5) ◽

pp. 637-643 ◽

Cited By ~ 22

Author(s):

M. H. Kemperman ◽

C. Stinckens ◽

S. Kumar ◽

P. L. M. Huygen ◽

F. B. M. Joosten ◽

...

Keyword(s):

Hearing Loss ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct

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Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops

Case Reports in Otolaryngology ◽

10.1155/2017/6195317 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Massimo Ralli ◽

Giuseppe Nola ◽

Luca Sparvoli ◽

Giovanni Ralli

Keyword(s):

Hearing Loss ◽

Intracranial Pressure ◽

Endolymphatic Hydrops ◽

Correct Diagnosis ◽

Ct Scans ◽

Vestibular Disorders ◽

Hearing Improvement ◽

Enlarged Vestibular Aqueduct ◽

Vestibular Aqueduct ◽

Inner Ear Malformation

Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH.

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