Cochlear implant in patient with narrow internal auditory canal: a case report

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  • 人工内耳埋め込みが有効であった両側内耳道狭窄の１症例

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A 3-year-old female was born as the second child of twins in 34 weeks pregnancy. Comparedwith twins' elder sister, the delay of lingual development has been conspicuous at one anda half years old. She had no response to auditory brainstem response (ABR). Computed tomography (CT) of the inner ear showed very narrow internal auditory canals bilaterally. Magnetic resonance imaging (MRI) revealed the internal auditory canal was very narrow and the cochlear nerve bunch was not delineated.<BR>Under general anesthesia electrophysiologic tests including distortion product otoacoustic emission (DPOAE), auditory steady-state response (ASSR), electrocochleogram (ECoG), electrically evoked auditory brain stem response (EABR) were performed. EABR testing showed that there was response only in the left side. Therefore, cochlear implantation was performed in the left side using CI24M. Neural response telemetry (NRT) during the operation showed observable response from all electrodes. The mapping with ACE strategy was possible using all electrodes at the time of switch-on. Afterswitch-on, Speech performance is developing.<BR>MRI is not totally reliable to delineate the thin cochlear nerve in the narrow internal auditory canal. EABR should be indicated to decide candidate for cochler implant even in cases with very poor sound responses and an uncertain image of cochlear nerve. Therefore, it is necessary to perform adequate electrophysiologic tests.

Journal

  • Otology Japan

    Otology Japan 14 (3), 248-251, 2004

    Japan Otological Society

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