![]() ![]() Therefore, the demonstration of variants of complex combined anomalies with a positive effect of CI is useful for resolving the issue of surgery when faced with similar cases. The presence of several anomalies of the temporal bone further complicates the decision to operate. ![]() There is an opinion that modern imaging methods cannot accurately reflect the state of the cochlear nerve or predict the benefit of CI for a child. The increase in the number of such patients requires clear indications for CI, as it has an economic interest. The results of the studies should be evaluated by an experienced radiologist to determine contraindications and assess the likelihood of intraoperative complications. To determine the indications for cochlear implantation in children with complex temporal bone malformations, it is necessary to perform high-resolution computed tomography (CT) of the temporal bones and 3 T magnetic resonance imaging (MRI) of the cochlear nerves. The absence of the auditory nerve is a contraindication to surgery, and the correct assessment of its condition in case of hypoplasia essentially determines the fate of a deaf child.ĬI in cases of severe combined ear anomalies is associated with a high risk of intra and postoperative complications and poor results. Ībnormal middle ear anatomy affects surgical landmarks and in some cases makes it difficult to identify the cochlea. Regarding the anomalies of the inner ear, the greatest doubts in terms of the prospects of cochlear implantation (CI) are the absence or induration of the modiolus, stenosis/obliteration of the cochlear aperture and the dubious condition of the cochlear nerve. At the same time, aplasia/hypoplasia of the cochlear nerve can occur both in stenotic and normal internal auditory canal (IAC). Such a combination-a common cavity and an undivided vestibulocochlear nerve-is a prognostically quite favorable option.Ĭongenital malformations of the inner ear structures can occur in various combinations and be combined with anomalies of the outer and middle ear, as well as aplasia/hypoplasia of the cochlear nerve. In the presence of a large or small common cavity, an undivided vestibulocochlear nerve is not considered a contraindication for CI. In this situation, the presence of a modiolus and at least partially open cochlear aperture are prognostically favorable. In the presence of a normal or dysplastic cochlea, a hypoplastic auditory nerve is not a contraindication for CI. The most critical is the state of the following structures: cochlea-modiolus-cochlear aperture-diameter of the internal auditory canal-the presence and condition of the auditory nerve. When determining indications for CI in children with complex anomalies, it is necessary to assess the state of all ear structures in computed tomography of the temporal bones and MR (3 Tesla) images. However, CI was carried out with favorable results in terms of hearing and speech development. Both patients had rare combinations of ear and auditory nerve anomalies associated with a high risk of intra- and postoperative complications during cochlear implantation (CI) and poor results. doi:10.1002/lary.25168 doi:10.1002/lary.This case study presents the neuroradiological findings of two deaf children with CHARGE syndrome and oculo-auriculo-vertebral spectrum disease. Surgical management of Patulous Eustachian tube: A systematic review. Die Trommelfellmassage, Aufstieg und Niedergang eines vielversprechenden therapeutischen Konzeptes. Eustachian Tube Massage for Congestion.įeldmann H. Patulous Eustachian Tube.įlorida Naturopathic Medicine Association. Genetic and Rare Disease Information Center. Overview of Middle Ear Infections in Young Children. National Center for Biotechnology Information. Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. Interventions for adult Eustachian tube dysfunction: a systematic review. ![]() Anatomy, Head and Neck, Ear Eustachian Tube. ![]()
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