PubMed · 10660367
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R Laszig. 1999. [Ear surgery].. https://pubmed.ncbi.nlm.nih.gov/10660367/
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CT and MRT are now standard examinations prior to insertion of a cochlear implant. Both methods have advantages and disadvantages in terms of discovering potentially pathological structures in the inner ear. The aim of this study was to evaluate the pros and cons of using CT and MRT before cochlear implantation. CT is usually performed using axial planigraphic planes. Like MRT, bone-specific CT is helpful in the diagnosis of congenital and acquired changes within the inner ear. Congenital defects in the meatus acusticus internus, the endolymphatic duct and sac, the cochlea and the vestibulum can be diagnosed and also quantified. Infectious morphologic changes can be seen on CT images in their terminal residual state (sclerotic tissue). However, acute inflammation and fibrotic tissue is not visible on CT. T2-specific MRT images are very fluid sensitive and play a major role in preoperative cochlear implant diagnosis. This examination demonstrates fluid within the peri- and enolymphatic cave and permits the diagnostician to determine whether congenital or acquired diseases have destroyed such fluid-filled cavities. In order to demonstrate pathological changes in the temporal bone and neural structures in the inner ear, MRT is the preferred method. Displaying the modiolus and the cochlear nerve is extremely important because, in their absence, a cochlear implantation may be contra-indicated. MRT also demonstrates other neural structures such as the facial nerve. This information may be important for the surgeon, e.g. the state of the pneumatic system in the mastoid cavity (which is best visualised by bone-specific CT).
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Techniques for treating hearing loss comprise surgery, hearing aids and rehabilitation. Medical treatments are devolved to the correction of the cause of the loss of hearing, essentially infection. In hearing loss, surgery is routinely used to repair the consequences of chronic infection and of trauma. It is also used for treatment of otospongiosis. It is used to place vibratory or electric prostheses, which will increase the quality of indications for surgery. For instance, cochlear implants can be used in profound or total, bilateral hearing loss. In parallel, the quality and the miniaturisation of external auditory devices is improving. Rehabilitation, by helping to reconstitute missing factors, comprises a third technique of treatment of hearing loss.