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Rofo 2022; 194(10): 1132-1139
DOI: 10.1055/a-1826-0641
Pediatric Radiology

Diameter of the Cochlear Nerve Canal predicts Cochlear Nerve Deficiency in Children with Sensorineural Hearing Loss

Der Durchmesser des Canalis nervi cochlearis als Marker einer Cochlearisaplasie bei Kindern mit sensorineuraler Schwerhörigkeit
Martin Sorge
1   Department of Otolaryngology, University Hospital Leipzig, Germany
,
Ina Sorge
2   Pediatric Radiology, University Hospital Leipzig, Germany
,
Markus Pirlich
1   Department of Otolaryngology, University Hospital Leipzig, Germany
,
Michael Fuchs
3   Department of Phoniatrics and Audiology, University Hospital Leipzig, Germany
,
Sylvia Meuret
3   Department of Phoniatrics and Audiology, University Hospital Leipzig, Germany
,
Franz Wolfgang Hirsch
2   Pediatric Radiology, University Hospital Leipzig, Germany
,
Andreas Dietz
1   Department of Otolaryngology, University Hospital Leipzig, Germany
,
Daniel Gräfe 
2   Pediatric Radiology, University Hospital Leipzig, Germany
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Abstract

Purpose Detection of cochlear nerve deficiency (CND) is usually straightforward using magnetic resonance imaging (MRI). In patients in whom MRI cannot be performed or imaging provides equivocal findings, computed tomography (CT) of the temporal bone might offer indirect evidence of CND. Our study aimed to derive a cut-off value for the diameter of the cochlear nerve canal (CNC) and internal auditory canal (IAC) in temporal bone CT to predict CND.

Materials and Methods This retrospective study included 70 children with sensorineural hearing loss (32 with CND and 38 control patients). The height, width, and cross-sectional area of the IAC and diameter of the CNCs were determined using temporal bone CT. Receiver operating characteristic (ROC) and Student’s t-tests were performed for each parameter.

Results The mean diameter of the CNCs was significantly smaller in children with CND than in the control group (1.2 mm versus 2.4 mm, p < .001). The optimal threshold for CNC for separation of the two groups was 1.9 mm, resulting in a sensitivity of 98.7 % and specificity of 89.2 %. The IAC dimensions could not distinguish between children with CND and controls.

Conclusion A CNC diameter of less than 1.9 mm is a reliable predictor of CND in children with sensorineural hearing loss.

Key Points: 

  • A small cochlear nerve canal predicts cochlear nerve deficiency (CND)

  • The size of the internal auditory canal cannot predict CND

  • Whenever MRI is impossible or ambigous, CT can rule out CND

Citation Format

  • Sorge M, Sorge I, Pirlich M et al. Diameter of the Cochlear Nerve Canal predicts Cochlear Nerve Deficiency in Children with Sensorineural Hearing Loss. Fortschr Röntgenstr 2022; 194: 1132 – 1139

Zusammenfassung

Ziel Eine Nervus-Cochlearis-Defizienz (CND) kann mittels Magnetresonanztomografie (MRT) in der Regel einfach diagnostiziert werden. Bei Patienten, bei denen eine MRT kontraindiziert ist oder keine eindeutigen Ergebnisse erbringt, kann die Computertomografie (CT) des Schläfenbeins einen indirekten Nachweis der CND liefern. Ziel unserer Studie war es, einen Schwellenwert für den Durchmesser des Canalis nervi cochlearis (CNC) und des inneren Gehörgangs (IAC) im Schläfenbein-CT für die Vorhersage einer CND zu ermitteln.

Material und Methoden An der retrospektiven Studie nahmen 70 Kinder mit Innenohrschwerhörigkeit teil (32 mit CND und 38 Kontrollpatienten). Die Höhe, Breite und Querschnittsfläche der IAC und der Durchmesser der CNC wurden mittels Schläfenbein-CT bestimmt. Für jeden Parameter wurde eine Receiver Operating Characteristic (ROC) und ein Studentʼs t-Tests durchgeführt.

Ergebnisse Der mittlere Durchmesser der CNCs war bei Kindern mit CND deutlich kleiner als in der Kontrollgruppe (1,2 mm gegenüber 2,4 mm, p < .001). Der optimale Schwellenwert zur Unterscheidung der beiden Gruppen lag für den CNC bei 1,9 mm mit einer Sensitivität von 98,7 % und einer Spezifität von 89,2 %. Die Dimensionen des IAC waren für die Unterscheidung zwischen Kindern mit und ohne CND nicht geeignet.

Schlussfolgerungen Ein CNC-Durchmesser unter 1,9 mm ist ein zuverlässiger Prädiktor für CND bei Kindern mit sensorineuralem Hörverlust.

Kernaussagen: 

  • Ein kleiner Canalis nervi cochlearis ist ein exzellenter Prädiktor einer Nervus-Cochlearis-Defizienz (CND)

  • Die Größe des inneren Gehörgangs hingegen ist kein guter Prädiktor

  • Wenn eine MRT kontraindiziert ist, kann die CT eine CND ausschließen

Key words

internal auditory canal - cochlear implantation - cochlear nerve dysplasia - cochlear nerve canal


Publication History

Received: 20 December 2021

Accepted: 22 March 2022

Article published online:
01 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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