Koklear implantasyon adayı hastaların yüksek rezolüsyonlu bilgisayarlı tomografi ve manyetik rezonans inceleme sonuçları

Amaç: Sensörinöral işitme kaybı nedeniyle koklear implantasyon planlanan hastalarda, operasyonun şeklini ve başarısını etkileyebilcek faktörlerin, yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT) ve manyetik rezonans inceleme (MRI) ile değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Çalışmaya alınan 49 hastadan 38’ine MRI yapılırken, tüm hastalara YRBT uygulanmıştır. MRI ve YRBT görüntüleri; mastoid hücre pnömatizasyonu, sigmoid sinüsün lokalizasyonu, aberan vasküler yapılar, konjenital anomaliler, koklear stenoz, labirent ossifikasyonu, internal akustik kanal genişliği, vestibülokoklear sinirin varlığı, enfeksiyon varlığı, semisirküler kanallar, serebellopontin bölge, koklear ve vestibüler akuadukt genişliği yönünden değerlendirilmiştir. Bulgular: Hastaların yaşları 1 yaş ile 61 yaş arasında (ortalama 12.3 yıl) değişmekte olup, 29 erkek ile 20 kadından oluşmaktadır. Hastaların 35’inde (%71.4) iç kulağa ait çeşitli patolojiler yada konjenital malformasyonlar izlenmiştir. Yine 98 kulak üzerinde yapılan incelemede, 58 kulakta (%59.3) 1. derece, 23 kulakta (%23.4) 2. derece ve 17 kulakta (%17.3) 3. derece mastoid havalanma saptanmıştır. Mastoid hücre havalanmasından sigmoid sinus pozisyonunun (p

Results of cochlear implantation candidate patients by high resolution computed tomography and magnetic resonance imaging

Objectives: To evaluate the effectiveness of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) for assessment of factors which would influence the type and success of surgery in patients undergoing cochlear implantation. Materials and methods: All patients underwent HRCT imaging while MRI was performed in 38 of them. MRI and HRCT images were evaluated for mastoid cell pneumatization, sigmoid sinus localization, aberrant vascular structures, congenital anomalies, cochlear stenosis, labyrinth ossification, infection, internal acoustic canal width, presence of vestibulo-cochlear nerve, semicircular canals, cerebellopontin area, and cochlear and vestibular aquaduct width. Results: Totally 49 patients (29 males and 20 females with a mean age of 12.3 years (1 - 61 years) were included. Various abnormalities or congenital anomalies were found in 35 patients by HRCT and MRI. We observed grade 1 mastoid cell pneumatization in 58 ears (59.3%), grade 2 in 23 (23.4%) and grade 3 in 17. Furthermore the position of sigmoid sinus (p<0.001) and mastoid width (p<0.001) were affected by mastoid cell ventilation. HRCT provides knowledge about mastoid and middle ear ventilation, cortical bone thickness, round window niche, perilymphatic-endolymphatic compartment and status of internal acoustic canal. Pathologies such as otosclerosis and Paget disease that involve otic capsule can be revealed by CT. MRI can provide views of intracochlear viscosity and cochlear opening, semicircular canals, cerebellopontin area, and vestibulocochlear nerve. Conclusions: HRCT and MRI provide information about the etiology of hearing loss, suitable side for cochlear implantation and detection of abnormalities or anatomic variations that may cause complications introperatively.

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