Lukas Woltersdorf (Bielefeld), Rayoung Kim (Bielefeld), Alexander Rempen (Bielefeld), Christoph Pfeiffer (Bielefeld), Alexander Kilgué (Bielefeld), Conrad Riemann (Bielefeld), Lars-Uwe Scholtz (Bielefeld), Daniela Eickenjäger (Gütersloh), Rüdiger Steinbach (Bielefeld), Ingo Todt (Bielefeld)
Introduction: Cochlea implantation is the treatment of choice for severe hearing loss and deafness. Cholesteatomas or paragangliomas can cause this deafness. A frequently used procedure in the course of surgical rehabilitation is subtotal petrosectomy with closure of the external auditory canal. The usual follow-up involves specific MRI sequences (EPI sequences). The evaluation of residual cholesteatomas or paragangliomas in combination with a cochlear implant is considerably more difficult due to artefact effects. Recent developments in combination with cochlea implants and necessary MRI examinations often enable the assessment of the internal auditory canal and cochlea. This study aimed to develop a procedure for detecting cholesteatomas in patients with cochlear implants using MRI.
Methods: Ex vivo MRI examinations were performed on five subjects with fixed cochlear implants (Medel Synchrony). MRI examinations were conducted at 1.5 T and 3 T using T1, T2, EPI, HASTE and Resolve sequences (Siemens). The implant was positioned 11 cm distal to the external auditory canal, with a specific head position during the MRI.
Results: Due to artefact effects, the assessment of the ipsilateral and contralateral mastoid is not possible in EPI sequences with a cochlear implant. The combination of cholesteatoma-detecting MARS sequences (magnetic artefact reduction sequences), a distal implant position, and a specific head position allows the assessment of the ipsilateral mastoid.
Conclusion: Postoperative cholesteatoma assessment after CI implantation and subtotal petrosectomy appears to be possible under 1.5 T and 3 T, considering the MRI sequence, implant position and head position.
Nein
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