Neuroradiologische Diagnostik bei Patienten mit sensorineuralem Hörverlust vor Cochlea-Implantation

Zusammenfassung

Die Cochlea-Implantation (CI) ist eine etablierte Technik, um Patienten mit bilateralem schwerem sensorineuralem Hörverlust (SNHV) ein Sprachverständnis zu ermöglichen. Eine präzise präoperative radiologische Diagnostik ist Grundlage für die Entscheidung zur Anlage eines Cochlea-Implantates und die erfolgreiche Durchführung der Implantation. Für die Bildgebung stehen CT, konventionelle und funktionelle MRT zur Verfügung. Dabei ist die Kenntnis der häufigsten kongenitalen syndromalen, nichtsyndromalen und erworbenen Fehlbildungen des Innenohres essenziell. Dieser Artikel bietet eine Übersicht zu den Methoden der Bildgebung vor CI und die wichtigsten Malformationen des Innenohres. Zudem werden Sicherheitsaspekte zur Durchführung einer MR-Bildgebung bei Patienten mit Cochlea-Implantat diskutiert.

Abstract

Cochlear implantation (CI) is an established technique for enabling speech perception in patients suffering from severe bilateral sensorineural hearing loss (SNHL). Thorough preoperative radiological assessment is essential for correctly evaluating the indication for surgery and safely performing cochlear implantation. CT and conventional and functional MRI are available for radiological assessment. Therefore, knowledge of the most frequent congenital syndromal, non-syndromal, and acquired malformations of inner ear structures is fundamental. This article provides information about imaging techniques prior to CI and relevant malformations of the inner ear. Safety aspects for patients with a cochlear implant undergoing MR imaging are also discussed.

Key words

CT - hearing loss - MR imaging - cochlear implant - inner ear malformations - MR safety

Literatur

• 1 Copeland B J, Pillsbury 3rd H C. Cochlear implantation for the treatment of deafness.  Annu Rev Med. 2004;  55 157-167
• 2 Scholtz L U, Mueller J, Schoen F. et al . Fast stimulator cochlear implants in patients with residual hearing.  Adv Otorhinolaryngol. 2000;  57 401-404
• 3 Mueller J. Die apparative Versorgung der Schwerhörigkeit: Cochlea-Implantate und Hirnstammimplantate - Aktuelle Entwicklungen der letzten 10 Jahre.  Laryngo-Rhino-Otol. 2005;  84 60-69
• 4 Tanioka H, Shirakawa T, Machida T. et al . Three-dimensional reconstructed MR imaging of the inner ear.  Radiology. 1991;  178 141-144
• 5 Casselman J W, Kuhweide R, Deimling M. et al . Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle.  AJNR Am J Neuroradiol. 1993;  14 47-57
• 6 Schild H. Klinische Hochfeld-MRT.  Fortschr Röntgenstr. 2005;  177 621-631
• 7 Rottgen R, Haltaufderheide K, Schroder R J. et al . Auswirkung der Feldstärke bei der standardisierten Kernspintomografie des Gehirns am Beispiel der Darstellung der Hirnnerven und Gefäßen in den basalen Zisternen: Vergleich zwischen 1,5 und 3,0 Tesla.  Fortschr Röntgenstr. 2005;  177 530-535
• 8 Ogawa S, Lee T M, Kay A R. et al . Brain magnetic resonance imaging with contrast dependent on blood oxygenation.  Proc Natl Acad Sci USA. 1990;  87 9868-9872
• 9 Logothetis N K, Pauls J, Augath M. et al . Neurophysiological investigation of the basis of the fMRI signal.  Nature. 2001;  412 150-157
• 10 Bartsch A J, Homola G, Biller A. et al . Diagnostic functional MRI: Illustrated clinical applications and decision-making.  J Magn Reson Imaging. 2006;  23 921-932
• 11 Bartsch A J, Specht K, Homola G. et al . Scanning for the scanner: FMRI of audition by read-out omissions from echo-planar imaging.  NeuroImage. im Druck; 
• 12 Bartsch A J, Beckmann C F, Thesen S. et al . Clinical FMRI of audition by simple EPI modification through read-out (R/O) omission.  Neuroradiology. 2004;  46 S98
• 13 Morzaria S, Westerberg B D, Kozak F K. Systematic review of the etiology of bilateral sensorineural hearing loss in children.  Int J Pediatr Otorhinolaryngol. 2004;  68 1193-1198
• 14 Lapointe A, Viamonte C, Morriss M C. et al . Central nervous system findings by magnetic resonance in children with profound sensorineural hearing loss.  Int J Pediatr Otorhinolaryngol. 2006;  70 863-868
• 15 Simons J P, Mandell D L, Arjmand E M. Computed tomography and magnetic resonance imaging in pediatric unilateral and asymmetric sensorineural hearing loss.  Arch Otolaryngol Head Neck Surg. 2006;  132 186-192
• 16 Smith R J, Bale Jr J F, White K R. Sensorineural hearing loss in children.  Lancet. 2005;  365 879-890
• 17 McClay J E, Tandy R, Grundfast K. et al . Major and minor temporal bone abnormalities in children with and without congenital sensorineural hearing loss.  Arch Otolaryngol Head Neck Surg. 2002;  128 664-671
• 18 Geurkink N A. Surgical anatomy of the temporal bone posterior to the internal auditory canal: an operative approach.  Laryngoscope. 1977;  87 975-986
• 19 Scholtz A W, Fish 3rd J H, Kammen-Jolly K. et al . Goldenhar’s syndrome: congenital hearing deficit of conductive or sensorineural origin? Temporal bone histopathologic study.  Otol Neurotol. 2001;  22 501-505
• 20 Swartz J D. Sensorineural hearing deficit: a systematic approach based on imaging findings.  Radiographics. 1996;  16 561-574
• 21 Jackler R K, Luxford W M, House W F. Congenital malformations of the inner ear: a classification based on embryogenesis.  Laryngoscope. 1987;  97 2-14
• 22 Graham J M, Phelps P D, Michaels L. Congenital malformations of the ear and cochlear implantation in children: review and temporal bone report of common cavity.  J Laryngol Otol Suppl. 2000;  25 1-14
• 23 Bisdas S, Lenarz M, Lenarz T. et al . Inner ear abnormalities in patients with Goldenhar syndrome.  Otol Neurotol. 2005;  26 398-404
• 24 Marangos N. Dysplasia of the inner ear and inner ear canal.  HNO. 2002;  50 866-880
• 25 Molter D W, Pate Jr B R, McElveen Jr J T. Cochlear implantation in the congenitally malformed ear.  Otolaryngol Head Neck Surg. 1993;  108 174-177
• 26 Cho H, Nakai Y, Ezaki Y. et al . Light and electron microscopic studies of a case with simultaneous Mondini and Michel deformities of the inner ears.  Arch Otorhinolaryngol. 1987;  243 361-365
• 27 Wootten C T, Backous D D, Haynes D S. Management of cerebrospinal fluid leakage from cochleostomy during cochlear implant surgery.  Laryngoscope. 2006;  116 2055-2059
• 28 Ramirez-Camacho R, Berrocal J RG, Trinidad B AA. Familial isolated unilateral large vestibular aqueduct syndrome.  J Otorhinolayrngol Relat Spec. 2003;  65 45-48
• 29 Park A H, Kou B, Hotaling A. et al . Clinical course of pediatric congenital inner ear malformations.  Laryngoscope. 2000;  110 1715-1719
• 30 Davidson H C, Harnsberger H R, Lemmerling M M. et al . MR evaluation of vestibulocochlear anomalies associated with large endolymphatic duct and sac.  Am J Neuroradiol. 1999;  20 1435-1441
• 31 Valvassori G E. The large vestibular aqueduct and associated anomalies of the inner ear.  Otolaryngol Clin North Am. 1983;  16 95-101
• 32 Harnsberger H R, Dahlen R T, Shelton C. et al . Advanced techniques in magnetic resonance imaging in the evaluation of the large endolymphatic sac and sac syndrome.  Laryngoscope. 1995;  105 1037-1042
• 33 Dahlen R T, Harnsberger H R, Gray S D. et al . Overlapping thin section fast spin echo MR of the large vestibular aqueduct syndrome: Comparison with CT.  Am J Neuroradiol. 1997;  18 67-75
• 34 Casselman J W, Offeciers E F, De Foer B. et al . CT and MR imaging of congential abnormalities of the inner ear and internal auditory canal.  Eur J Radiol. 2001;  40 94-104
• 35 Purcell D D, Fischbein N J, Patel A. et al . Two temporal bone computed tomography measurements increase recognition of malformations and predict sensorineural hearing loss.  Laryngoscope. 2006;  116 1439-1446
• 36 Lemmerling M M, Vanzieleghem B D, Mortier G R. et al . Unilateral semicircular canal aplasia in Goldenhar’s syndrome.  Am J Neuroradiol. 2000;  21 1334-1336
• 37 Nadol Jr J B, Burgess B. Cochleosaccular degeneration of the inner ear and progressive cataracts inherited as an autosomal dominant trait.  Laryngoscope. 1982;  92 1028-1037
• 38 Lalwani A K, Linthicum F H, Wilcox E R. et al . A five-generation family with late-onset progressive hereditary hearing impairment due to cochleosaccular degeneration.  Audiol Neurootol. 1997;  2 139-154
• 39 Sampaio A L, Cureoglu S, Schachern P A. et al . Cochleosaccular dysplasia: a morphometric and histopathologic study in a series of temporal bones.  Otol Neurotol. 2004;  25 530-535
• 40 Antonelli P J, Nall A V, Lemmerling M M. et al . Hearing loss with cochlear modiolar defects and large vestibular aqueducts.  Am J Otol. 1998;  19 306-312
• 41 Lemmerling M M, Mancuso A A, Antonelli P J. et al . Normal modiolus: CT appearance in patients with a large vestibular aqueduct.  Radiology. 1997;  204 213-219
• 42 Goldfeld M, Glaser B, Nassir E. et al . CT of the ear in Pendred syndrome.  Radiology. 2005;  235 537-540
• 43 Witte R J, Lane J I, Driscoll C L. et al . Pediatric and adult cochlear implantation.  Radiographics. 2003;  23 1185-1200
• 44 Thai-H, Fraysse B, Berry I. et al . Functional magnetic resonance imaging may avoid misdiagnosis of cochleovestibular nerve aplasia in congenital deafness.  Am J Otol. 2000;  21 663-670
• 45 Phelps P D, Annis J A, Robinson P J. Imaging for cochlear implants.  Br J Radiol. 1990;  63 512-516
• 46 Glastonbury C M, Davidson H C, Harnsberger H R. et al . Imaging findings of cochlear nerve deficiency.  Am J Neuroradiol. 2002;  23 635-643
• 47 Cho Y S, Na D G, Jung J Y. et al . Narrow internal auditory canal syndrome: parasagittal reconstruction.  J Laryngol Otol. 2000;  114 392-394
• 48 Casselman J W, Offeciers F E, Govaerts P J. et al . Aplasia and hypoplasia of the vestibulocochlear nerve: diagnosis with MR imaging.  Radiology. 1997;  202 773-781
• 49 Miura M, Sando I, Takasaki K. et al . Histopathologic study of temporal bone and eustachian tube in oculoauriculovertebral spectrum.  Ann Otol Rhinol Laryngol. 2001;  110 922-927
• 50 Shelton C, Luxford W M, Tonokawa L L. et al . The narrow internal auditory canal in children: a contraindication to cochlear implants.  Otolaryngol Head Neck Surg. 1989;  100 227-231
• 51 Papsin B C. Cochlear implantation in children with anomalous cochleovestibular anatomy.  Laryngoscope. 2005;  115 1-26
• 52 Kim L S, Jeong S W, Huh M J. et al . Cochlear implantation in children with inner ear malformations.  Ann Otol Rhinol Laryngol. 2006;  115 205-214
• 53 Veillon F, Casselman J W, Offeciers E F. et al . Facial nerve: congenital malformations part 2, congenital abnormal course of the facial nerve in the cerebellopontine angle or internal auditory canal [Abstract].  J Belge Radiologie. 1999;  82 187-188
• 54 Mayer T E, Brueckmann H, Siegert R. et al . High-resolution CT of the temporal bone in dysplasia of the auricle and external auditory canal.  Am J Neuroradiol. 1997;  18 53-65
• 55 Ellul S, Shelton C, Davidson H C. et al . Preoperative cochlear implant imaging: is magnetic resonance imaging enough?.  Am J Otol. 2000;  21 528-533
• 56 Nair S B, Abou-Elhamd K A, Hawthorne M. A retrospective analysis of high resolution computed tomography in the assessment of cochlear implant patients.  Clin Otolaryngol Allied Sci. 2000;  25 55-61
• 57 Casselman J W, Bensimon J L. Imaging of the inner ear.  Radiologe. 1997;  37 954-663
• 58 Jackler R K, Dillon W P. Computed tomography and magnetic resonance imaging of the inner ear.  Otolaryngol Head Neck Surg. 1988;  99 494-504
• 59 Casselman J W. Diagnostic imaging in clinical neuro-otology.  Curr Opin Neurol. 2002;  15 23-30
• 60 Balkany T, Gantz B J, Steenerson R L. et al . Systematic approach to electrode insertion in the ossified cochlea.  Otolaryngol Head Neck Surg. 1996;  114 4-11
• 61 Menger D J, Tange R A. The aetiology of otosclerosis: a review of the literature.  Clin Otolaryngol Allied Sci. 2003;  28 112-120
• 62 Pauw R J, De Leenheer E M, Van Den Bogaert K. et al . The phenotype of the first otosclerosis family linked to OTSC5.  Otol Neurotol. 2006;  27 308-315
• 63 Rotteveel L J, Proops D W, Ramsden R T. et al . Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications.  Otol Neurotol. 2004;  25 943-952
• 64 Linthicum Jr F H. Histopathology of otosclerosis.  Otolaryngol Clin North Am. 1993;  26 335-352
• 65 Mafee M F, Valvassori G E, Deitch R L. et al . Use of CT in the evaluation of cochlear otosclerosis.  Radiology. 1985;  156 703-708e
• 66 Wackym P A, Michel M A, Prost R W. et al . Effect of magnetic resonance imaging on internal magnet strength in Med-El Combi 40 + cochlear implants.  Laryngoscope. 2004;  114 1355-1361
• 67 Teissl C, Kremser C, Hochmair E S. et al . Cochlear implants: in vitro investigation of electromagnetic interference at MR imaging - compatibility and safety aspects.  Radiology. 1998;  208 700-708
• 68 Youssefzadeh S, Baumgartner W, Dorffner R. et al . MR compatibility of Med EL cochlear implants: clinical testing at 1.0 T.  J Comput Assist Tomogr. 1998;  22 346-350
• 69 Sonnenburg R E, Wackym P A, Yoganandan N. et al . Biophysics of cochlear implant/MRI interactions emphasizing bone biomechanical properties.  Laryngoscope. 2002;  112 1720-1725
• 70 Portnoy W M, Mattucci K. Cochlear implants as a contraindication to magnetic resonance imaging.  Ann Otol Rhinol Laryngol. 1991;  100 195-197