Incomplete Partition Type III: Computed Tomography Features and Cochlear Implantation Complications

In this case report, we review a male child who presented with severe bilateral hearing loss. Preoperative high-resolution computed tomography (HRCT) evaluation facilitated the initial diagnosis of the disease, which revealed typical findings of cochlear incomplete partition type III anomaly (IP-III), surgical planning, and cochlear implant selection to avoid possible complications. The child underwent cochlear implantation, which resulted in gushing and misplacement of the electrodes into the internal auditory canal (IAC) as postoperative complications. Postoperative imaging was used to determine the position of the implant and to assess the complications. The child’s postoperative X-ray revealed misplacement of the cochlear implant, the extent of which was further assessed by a HRCT scan for preplanning the revision surgery and electrode selection. Following the revision surgery, a further HRCT scan confirmed proper implantation and ruled out any further complications.

Download Full-text

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).

Download Full-text

Radiological measurement of cochlear dimensions in cochlear hypoplasia and its effect on cochlear implant selection

The Journal of Laryngology & Otology ◽

10.1017/s0022215121000979 ◽

2021 ◽

pp. 1-7

Author(s):

G Pamuk ◽

A E Pamuk ◽

A Akgöz ◽

M D Bajin ◽

B Özgen ◽

...

Keyword(s):

Cochlear Implant ◽

Lateral Wall ◽

Control Group ◽

Type I ◽

Basal Turn ◽

Radiological Measurement ◽

Computed Tomography Images ◽

Implant Selection ◽

Incomplete Partition ◽

Electrode Selection

Abstract Objective To determine the effect of cochlear dimensions on cochlear implant selection in cochlear hypoplasia patients. Methods Temporal bone computed tomography images of 36 patients diagnosed with cochlear hypoplasia between 2010 and 2016 were retrospectively reviewed and compared with those of 40 controls without sensorineural hearing loss. Results Basal turn length and mid-modiolar height were significantly lower in the cochlear hypoplasia patients with subtypes I, II and III than in the control group (p < 0.001). Mid-scalar length was significantly shorter in subtype I–III patients as compared with the control group (p < 0.001). In addition, cochlear canal length (measured along the lateral wall) was significantly shorter in subtype I–IV patients than in the control group (subtypes I–III, p < 0.001; subtype IV, p = 0.002) Conclusion Cochlear hypoplasia should be considered if basal turn length is less than 7.5 mm and mid-modiolar height is less than 3.42 mm. The cochlear implant should be selected according to cochlear hypoplasia subgroup. It is critically important to differentiate subtype II from incomplete partition type I and subtype III from a normal cochlea, to ensure the most appropriate implant electrode selection so as to optimise cochlear implantation outcomes.

Download Full-text

A Revision Surgery for Cochlear Implantation in a Case of Incomplete Partition Type I

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15107 ◽

2016 ◽

Vol 27 (10) ◽

pp. 846-850 ◽

Cited By ~ 2

Author(s):

Habib G. Rizk ◽

Francesca Hagood ◽

Meredith A. Holcomb ◽

Ted A. Meyer

Keyword(s):

Cochlear Implant ◽

Inner Ear ◽

Revision Surgery ◽

Cochlear Implantation ◽

Type I ◽

Facial Recess ◽

Long Term Follow Up ◽

Incomplete Partition

Background: Patients with cochlear malformations were long considered poor candidates for cochlear implantation (CI), and surgical approaches different than the standard facial recess approach were used to access the inner ear. There is no previous long-term follow-up of a patient with significantly malformed inner ear operated through an untraditional route and requiring a revision surgery. Purpose: This case provides a long-term follow-up from the initial surgery, a short-term follow-up from the revision surgery, and it illustrates the evolving classification of inner ear malformations as well as the potential problems associated with nonstandard approaches to the cochlea. Research Design: A case report. Intervention: Herein, we report a case of revision CI in a patient with incomplete partition type I, through the round window via a facial recess approach, 18 yr after an initial implantation via a transmastoid labyrinthotomy approach. Results: The patient had an uncomplicated surgery, and after activation, she noted auditory perception on all electrodes without facial stimulation. A sound field sound awareness threshold was obtained at 15 dB HL. Conclusions: As the prior generation of cochlear implant recipients ages, the probability of a revision surgery for various causes increases. Cochlear implant surgeons should be aware of the potential pitfalls associated in these often challenging cases.

Download Full-text

Cochlear Implant in Patients with Incomplete Partition Type III

Korean Journal of Otolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2009.52.6.492 ◽

2009 ◽

Vol 52 (6) ◽

pp. 492 ◽

Cited By ~ 1

Author(s):

Jae Hyuk Choi ◽

Kyu Yup Lee ◽

Eun Jung Lim ◽

Sang Heun Lee

Keyword(s):

Cochlear Implant ◽

Type Iii ◽

Incomplete Partition

Download Full-text

Cochlear implantation in cases with incomplete partition type III (X-linked anomaly)

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-008-0778-6 ◽

2008 ◽

Vol 265 (11) ◽

pp. 1439-1439

Author(s):

Armagan Incesulu ◽

Baki Adapinar ◽

Cem Kecik

Keyword(s):

Cochlear Implantation ◽

Type Iii ◽

Incomplete Partition

Download Full-text

Cochlear implantation using a custom guide catheter in 14 patients with incomplete partition type III

Clinical Otolaryngology ◽

10.1111/coa.13146 ◽

2018 ◽

Vol 43 (5) ◽

pp. 1379-1383 ◽

Cited By ~ 1

Author(s):

H. Tian ◽

L. Wang ◽

F. Gao ◽

W. Liang ◽

K.A. Peng

Keyword(s):

Cochlear Implantation ◽

Type Iii ◽

Guide Catheter ◽

Incomplete Partition

Download Full-text

Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

The Journal of Laryngology & Otology ◽

10.1017/s0022215116009555 ◽

2016 ◽

Vol 131 (1) ◽

pp. 26-31 ◽

Cited By ~ 9

Author(s):

F B Palabiyik ◽

K Hacikurt ◽

Z Yazici

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

High Resolution ◽

Facial Nerve ◽

Cochlear Implant ◽

Inner Ear ◽

Resonance Imaging ◽

High Resolution Computed Tomography ◽

Ear Anomalies

AbstractBackground:Pre-operative radiological identification of facial nerve anomalies can help prevent intra-operative facial nerve injury during cochlear implantation. This study aimed to evaluate the incidence and configuration of facial nerve anomalies and their concurrence with inner-ear anomalies in cochlear implant candidates.Methods:Inner-ear and concomitant facial nerve anomalies were evaluated by magnetic resonance imaging and temporal high-resolution computed tomography in 48 children with congenital sensorineural hearing loss who were cochlear implant candidates.Results:Inner-ear anomalies were present in 11 out of 48 patients (23 per cent) and concomitant facial nerve anomalies were present on 7 sides in 4 patients (7 per cent of the total). Facial nerve anomalies were accompanied by cochlear or vestibular malformation.Conclusion:Potential facial nerve abnormalities should always be considered in patients with inner-ear anomalies. Pre-operative facial nerve imaging can increase the surgeon's confidence to plan and perform cochlear implantation. Magnetic resonance imaging should be used to detect inner-ear anomalies; if these are identified, temporal high-resolution computed tomography should be used to evaluate the facial nerve.

Download Full-text

A study on modelling cochlear duct mid-scalar length based on high-resolution computed tomography, and its effect on peri-modiolar and mid-scalar implant selection

The Journal of Laryngology & Otology ◽

10.1017/s0022215119001671 ◽

2019 ◽

Vol 133 (09) ◽

pp. 764-769

Author(s):

G Pamuk ◽

A E Pamuk ◽

A Akgöz ◽

E Öztürk ◽

M D Bajin ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Round Window ◽

Chronic Otitis Media ◽

Lateral Wall ◽

High Resolution Computed Tomography ◽

Cochlear Duct ◽

Implant Selection ◽

Cochlear Duct Length ◽

Implant Length

AbstractObjectiveTo determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length.MethodsThe study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the ‘X’ line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured.ResultsCochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line.ConclusionUsing the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.

Download Full-text