S237 – Computerized Tomography in the Prediction of CSF Gusher

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P154-P155
Author(s):  
Vanessa S Rothholtz ◽  
Mahmood F Mafee ◽  
Nancy M Young

Objectives 1) Identify anatomic variations of the temporal bone in children with and without cochlear malformations who experienced an intra-operative cerebrospinal fluid (CSF) gusher at the time of cochlear implantation. 2) Compare the anatomic findings in the current study to those described in prior studies. Methods A retrospective case-controlled chart review was performed on patients undergoing cochlear implant surgery. Computerized tomography images were analyzed in a single-blind fashion for characteristics and measurements of both the right and left cochlea, internal auditory canal, cochlear aperture, facial nerve canal, vestibular aqueduct, cochlear aqueduct, oval window, round window, vestibule, mastoid, tegmen tympani and semi-circular canals. After verifying equal variances, data was statistically evaluated utilizing the paired 2-tailed t test with criterion for statistical significance set at p < 0.05. Results The average age at implantation for this series of children was 4 years old. 70% of patients had cochlear malformations. 25% of patients had an abnormal internal auditory canal (IAC) and 30% had a widened cochlear aperture. Most patients with an abnormal IAC had an abnormal cochlear aperture; however, some patients with a normal IAC also had an abnormal cochlear aperture. Correlations between the temporal bone anatomy and the incidence of CSF gushers will be discussed. Conclusions Specific characteristics of the temporal bone anatomy may lead to an increased incidence of CSF gusher in cochlear implant surgery. Computerized tomography of the temporal bone can assist in the surgeon in evaluation and planning for cochlear implantation.

Author(s):  
Suhail Rafiq ◽  
Fahad Shafi ◽  
Ajaz Mohiuddin ◽  
Sajjad A. Dar

<p class="abstract"><strong>Background:</strong> Congenital sensorineural hearing loss (SNHL) is one of the most common birth defects with incidence of approximately 1:1000 live births. Imaging plays an important role in the work up of cochlear implant candidates not only to identify inner ear congenital and acquired abnormalities or cochlear nerve anomalies but also to detect temporal bone abnormalities or variations that may alter surgical approach. Preoperative evaluation of cochleovestibular anatomy is an important component of the cochlear implant evaluation. The objective of the study was high resolution computerized tomography (HRCT) assessment of congenital ear anomalies before cochlear implantation.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the Department of Radio diagnosis and Imaging, GMC, Srinagar. 24 children in the age group of 1 to 12 years with unidentified causes of bilateral SNHL were subjected to HRCT over a period of 7 months from January to July 2019.  </p><p class="abstract"><strong>Results:</strong> Eighteen patients had normal radiological scans and 6 had congenital anomalies. We had one each case of common cavity, bilateral labrynthine aplasia, incomplete partition type 1, Mondini’s deformity with dilated vestibular duct, Internal auditory canal stenosis and bilateral large vestibular aqueduct. Out of 18 patients without congenital anomaly, two had Korner’s septum and giant jugular bulb which were important for operating surgeon.</p><p><strong>Conclusions:</strong> HRCT temporal bone is superior at identifying the bony labyrinth, including enlarged vestibular aqueduct and caliber of internal auditory canal. HRCT temporal bone should be supplemented by magnetic resonance imaging especially for cochlear nerve assessment. It is the initial imaging modality of choice for assessment of congenital SNHL. </p>


2016 ◽  
Vol 273 (12) ◽  
pp. 4225-4240 ◽  
Author(s):  
A. C. Vesseur ◽  
B. M. Verbist ◽  
H. E. Westerlaan ◽  
F. J. J. Kloostra ◽  
R. J. C. Admiraal ◽  
...  

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 25-31
Author(s):  
Dragan Dankuc ◽  
Darja Segan ◽  
Zoran Komazec ◽  
Ljiljana Vlaski ◽  
Slobodanka Lemajic-Komazec ◽  
...  

Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9%) and in 15 (15.1%), respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4%) children, whereas in four (4.6%) children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75%) manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%), hereditary factor in six (6.06%), and bacterial meningitis in four (4.04%) patients. Somewhat less common causes were perinatal hypoxia in three (3.03%), premature birth in three (3.03%), Down syndrome in one (1.01%), and chronic otitis media in one (1.01%) patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5%) were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative perilymph liquid gusher, device failure and late infections were recorded extremely rarely.


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054041
Author(s):  
Patorn Piromchai ◽  
Napas Tanamai ◽  
Sivaporn Kiatthanabumrung ◽  
Suwicha Kaewsiri ◽  
Kanthong Thongyai ◽  
...  

ObjectivesTo report the status and outcomes of cochlear implantation in Thailand.DesignCohort study.SettingTertiary care and university hospitals.ParticipantsPatients who underwent cochlear implant surgery in Thailand.InterventionsThis project collected data from all government and university hospitals in Thailand where cochlear implant surgery was performed between 2016 and 2020.Primary and secondary outcome measuresBaseline characteristics, operation data, complications, audiological outcomes and quality of life were reported.ResultsThis study included 458 patients, and nearly half of the patients were children and adolescents (46.94%). The mean age of the patients was 2.96±5.83 years. At 1 year postoperatively, the mean pure tone average of the hearing threshold in the implanted ear significantly improved from unaided preoperative baseline (mean difference (MD) 64.23 dB HL; 95% CI 59.81 to 68.65; p<0.001). The mean speech recognition threshold also improved (MD 55.96 dB HL; 95% CI 49.50 to 62.42, p<0.001). The quality-of-life scores of the EQ-5D-5L, PedsQL and HUI3 questionnaires at 1 year showed improved mobility (range, 0–5; MD 0.65; 95% CI 0.05 to 1.25; p=0.037), hearing (range, 0–6; MD 0.96; 95% CI 0.30 to 1.61; p=0.006) and speech (range, 0–5; MD 0.44; 95% CI 0.04 to 0.84; p=0.031). Common complications included electrode dislodgement (2.18%), vertigo (1.23%) and meningitis (1.93%).ConclusionsExcellent audiological outcomes and improvement in the quality of life in the mobility, hearing and speech domains were observed in patients who underwent cochlear implantation in Thailand.


2021 ◽  
pp. 1-10
Author(s):  
Michelle Truong ◽  
Christo Bester ◽  
Kumiko Orimoto ◽  
Maria Vartanyan ◽  
Debra Phyland ◽  
...  

BACKGROUND: Dizziness is a common perioperative complication after cochlear implantation (CI). To date, the exact cause behind this phenomenon remains unclear. There is recent evidence to suggest that otolith function, specifically utricular, may be affected shortly after CI surgery, however whether these changes are related to patient symptoms has not yet been investigated. OBJECTIVE: To determine whether CI surgery and perioperative dizziness is associated with changes on utricular function. METHODS: We performed an observational study on patients undergoing routine CI surgery. Utricular function was assessed using the Subjective Visual Vertical (SVV), and perioperative dizziness was determined using a questionnaire. The study followed patients before surgery and then again 1-day, 1-week and 6-weeks after implantation. RESULTS: Forty-one adult CI recipients participated in the study. The SVV deviated away from the operated ear by an average of 2.17° a day after implantation, 0.889° 1 week and –0.25° 6 weeks after surgery. Dizziness contributed to a tilt of 0.5° away from the implanted ear. These deviations were statistically significant. CONCLUSIONS: CI surgery causes utricular hyperfunction in the operated ear that resolves over 6 weeks. SVV tilts were greater in participants experiencing dizziness, suggesting that utricular hyperfunction may contribute to the dizziness.


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