Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
A Comparative Utility Study of Computed Tomography Versus Magnetic Resonance Imaging in the Preoperative Assessment of Adult Cochlear Implant Candidates.
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Wu Jasmine, Wong Kevin, Harley Randall, Shah Keshav V, Hwa Tiffany P, Bigelow Douglas C, Ruckenstein Michael J
Аннотация
OBJECTIVE: To compare the clinical utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the preoperative workup of adult cochlear implant (CI) candidates.
STUDY DESIGN: Retrospective chart review.
SETTING: Single tertiary care center.
PATIENTS: Four hundred ninety-six consecutive adults who underwent preoperative candidacy evaluation before cochlear implantation.
MAIN OUTCOME MEASURES: Positive findings on CT or MRI, perioperative outcomes, and device outcome measures [active electrodes, AzBio sentence scores, consonant-nucleus-consonant (CNC) word scores, and consonant-nucleus-consonant phoneme scores].
RESULTS: Four hundred ninety-six subjects were included. Mean age was 63.8 years (SD = 16.1). Three hundred seventy-two patients (75.0%) had preoperative MRI scans, 329 patients (66.3%) had CT scans, and 217 patients (43.8%) had both. Positive MRI findings led to a change in surgical management in 7 cases (1.9%): 3 decreased cochlear signal, 1 labyrinthitis ossificans, 1 cochlear malformation, 1 petrous apex lesion, and 1 vestibular schwannoma. CT led to change in management in 15 cases (4.6%): 5 labyrinthitis ossificans, 3 aberrant facial nerve, 4 sclerotic mastoid, 1 obstructing jugular bulb, 1 cochlear malformation, and 1 petrous apex lesion. Among 36 subjects with initial CT, 2 (5.6%) required subsequent MRI imaging; no subjects with initial MRI required additional CT imaging. No differences were found between imaging groups across device outcomes.
CONCLUSIONS: Both CT and MRI are suitable for preoperative planning before CI. CT is cost-effective and provides insight into surgical anatomy; however, MRI is the preferred single-modality option when indicated for providing definitive diagnostic information.
STUDY DESIGN: Retrospective chart review.
SETTING: Single tertiary care center.
PATIENTS: Four hundred ninety-six consecutive adults who underwent preoperative candidacy evaluation before cochlear implantation.
MAIN OUTCOME MEASURES: Positive findings on CT or MRI, perioperative outcomes, and device outcome measures [active electrodes, AzBio sentence scores, consonant-nucleus-consonant (CNC) word scores, and consonant-nucleus-consonant phoneme scores].
RESULTS: Four hundred ninety-six subjects were included. Mean age was 63.8 years (SD = 16.1). Three hundred seventy-two patients (75.0%) had preoperative MRI scans, 329 patients (66.3%) had CT scans, and 217 patients (43.8%) had both. Positive MRI findings led to a change in surgical management in 7 cases (1.9%): 3 decreased cochlear signal, 1 labyrinthitis ossificans, 1 cochlear malformation, 1 petrous apex lesion, and 1 vestibular schwannoma. CT led to change in management in 15 cases (4.6%): 5 labyrinthitis ossificans, 3 aberrant facial nerve, 4 sclerotic mastoid, 1 obstructing jugular bulb, 1 cochlear malformation, and 1 petrous apex lesion. Among 36 subjects with initial CT, 2 (5.6%) required subsequent MRI imaging; no subjects with initial MRI required additional CT imaging. No differences were found between imaging groups across device outcomes.
CONCLUSIONS: Both CT and MRI are suitable for preoperative planning before CI. CT is cost-effective and provides insight into surgical anatomy; however, MRI is the preferred single-modality option when indicated for providing definitive diagnostic information.