Skip to main content
Log in

CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Cochlear implantation has become an accepted treatment for deafness. As the frequency of cochlear implantation has increased, requests for images have also increased in the work-up for candidates. An absent cochlear nerve (CN) is a contraindication to cochlear implantation. Therefore, MRI is performed to evaluate the CN in patients with sensorineural hearing loss. Recently, some authors have reported the relationship between cochlear nerve canal (CNC) stenosis and CN hypoplasia.

Objective

To review the relationship between CNC and CN.

Materials and methods

During a period of 78 months, 21 children (42 ears) with unilateral or bilateral sensorineural hearing loss underwent both HRCT and MRI of the cochlear nerve. We retrospectively reviewed two factors: the evaluation of inner ear malformations and the relationship between CNC stenosis and CN hypoplasia.

Results

Inner ear malformations were recognized in ten ears. The mean CNC diameter was approximately 2 mm (ranging from 0.6 to 2.7 mm). CN hypoplasia was seen in eight of the 42 ears; all eight were associated with CNC stenosis (≤1.5 mm). Of the 34 ears with normal CN, 32 had CNC >1.5 mm in diameter and the remaining two ears, with incomplete partition type I, had CNC stenosis.

Conclusion

Children with CNC stenosis had a high incidence of CN hypoplasia. CNC stenosis (≤1.5 mm) suggests CN hypoplasia. On the other hand, CN hypoplasia was not seen in children with CNC diameter >1.5 mm. Therefore, we conclude that children with CNC stenosis or malformations on HRCT should receive MR imaging of the CN.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Adunka OF, Roush PA, Teagle HF et al (2006) Internal auditory canal morphology in children with cochlear nerve deficiency. Otol Neurotol 27:793–801

    Article  PubMed  Google Scholar 

  2. Lowe LH, Vezina LG (1997) Sensorineural hearing loss in children. Radiographics 17:1079–1093

    CAS  PubMed  Google Scholar 

  3. Russo EE, Manolidis S, Morriss MC (2006) Cochlear nerve size evaluation in children with sensorineural hearing loss by high-resolution magnetic resonance imaging. Am J Otolaryngol 27:166–172

    Article  PubMed  Google Scholar 

  4. Witte RJ, Lane JI, Driscoll CL et al (2003) Pediatric and adult cochlear implantation. Radiographics 23:1185–1200

    Article  PubMed  Google Scholar 

  5. Casselman JW, Offeciers FE, Govaerts PJ et al (1997) Aplasia and hypoplasia of the vestibulocochlear nerve: diagnosis with MR imaging. Radiology 202:773–781

    CAS  PubMed  Google Scholar 

  6. Glastonbury CM, Davidson HC, Harnsverger HR et al (2002) Imaging findings cochlear nerve deficiency. AJNR 23:635–643

    PubMed  Google Scholar 

  7. Kono T (2008) Computed tomographic features of the bony canal of the cochlear nerve in pediatric patients with unilateral sensorineural hearing loss. Radiat Med 26:115–119

    Article  PubMed  Google Scholar 

  8. Fatterpekar GM, Mukherji SK, Alley J et al (2000) Hypoplasia of the bony canal for the cochlear nerve in patients with congenital sensorineural hearing loss: initial observations. Radiology 215:243–246

    CAS  PubMed  Google Scholar 

  9. Komatsubara S, Haruta A, Nagano Y et al (2007) Evaluation of cochlear nerve imaging in severe congenital sensorineural hearing loss. ORL J Otorhinolaryngol Relat Spec 69:198–202

    PubMed  Google Scholar 

  10. Sennaroglu L, Saatci I (2002) A new classification for cochleovestibular malformations. Laryngoscope 112:2230–2241

    Article  PubMed  Google Scholar 

  11. Kim HS, Kim DI, Chung IH et al (1998) Topographical relationship of the facial and vestibulocochlear nerves in the subarachnoid space and internal auditory canal. AJNR 19:1155–1161

    CAS  PubMed  Google Scholar 

  12. Ferreira T, Shayestehfar B, Lufkin R (2003) Narrow, duplicated internal auditory canal. Neuroradiology 45:308–310

    CAS  PubMed  Google Scholar 

  13. Demir OI, Cakmakck H, Erdag TK et al (2005) Narrow duplicated internal auditory canal: radiological findings and review of the literature. Pediatr Radiol 35:1220–1223

    Article  PubMed  Google Scholar 

  14. Weon YC, Kim JH, Choi SK et al (2007) Bilateral duplication of the internal auditory canal. Pediatr Radiol 37:1047–1049

    Article  PubMed  Google Scholar 

  15. Bail HW, Yu H, Kim KS et al (2008) A narrow internal auditory canal with duplication in a patient with congenital sensorineural hearing loss. Korean J Radiol 9:S22–S25

    Article  Google Scholar 

  16. McClay JE, Booth TN, Parry DA et al (2008) Evaluation of pediatric sensorineural hearing loss with magnetic resonance imaging. Arch Otolaryngol Head Neck Surg 134:945–952

    Article  PubMed  Google Scholar 

  17. Trimble K, Blaser S, James AL et al (2007) Computed tomography and/or magnetic resonance imaging before pediatric cochlear implantation? Developing an investigative strategy. Otol Neurotol 28:317–324

    Article  PubMed  Google Scholar 

  18. Shim HJ, Shin JR, Chung JW et al (2006) Inner ear anomalies in cochlear implants: importance of radiologic measurements in the classification. Otol Neurotol 27:831–837

    Article  PubMed  Google Scholar 

  19. Jackler RK, Luxford WM, House WF (1987) Congenital malformations of the inner ear: a classification based on embryogenesis. Laryngoscope 97:2–14

    Article  CAS  PubMed  Google Scholar 

  20. Shelton C, Luxford WM, Tonokawa LL et al (1989) The narrow internal auditory canal in children: a contraindication to cochlear implants. Otolaryngol Head Neck Surg 100:227–231

    CAS  PubMed  Google Scholar 

  21. Adunka OF, Jewells V, Buchman CA et al (2007) Value of computed tomography in the evaluation of children with cochlear nerve deficiency. Otol Neurotol 28:597–604

    Article  PubMed  Google Scholar 

  22. Sennaroglu L, Saatci I, Aralasmak A et al (2002) Magnetic resonance imaging versus computed tomography in pre-operative evaluation of cochlear implant candidates with congenital hearing loss. J Laryngol Otol 116:804–810

    Article  PubMed  Google Scholar 

  23. Stjernholm C, Muren C (2002) Dimension of the cochlear nerve: a radioanatomic investigation. Acta Otolaryngol 122:43–48

    Article  PubMed  Google Scholar 

  24. Maxwell AP, Mason SM, O’Donoghue GM (1999) Cochlear nerve aplasia: its importance in cochlear implantation. Am J Otol 20:335–337

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mikiko Miyasaka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miyasaka, M., Nosaka, S., Morimoto, N. et al. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve. Pediatr Radiol 40, 1509–1516 (2010). https://doi.org/10.1007/s00247-010-1609-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-010-1609-7

Keywords

Navigation