Quantitative assessment of temporal skin elasticity using shear wave elastography in pediatric cochlear implant users

Ultrasound Elastography in Children

Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis evaluation in children; however, several other applications of the technique are available in both clinical practice and research environments. Practically, in children any organ can be assessed, including the brain in early ages, along with muscle and connective tissue elasticity evaluation, spleen, kidney, skin, lymphatic tissue, etc. The elastography method, age, body mass index and technical points should be considered when performing ultrasound elastography. This review highlights its vast potential as a diagnostic tool in the pediatric population, where ultrasound is a dominant imaging tool; however, the indications and exam protocol for its clinical use in several fields in pediatrics have yet to be elucidated.

Olfactory bulb volume in cochlear implant candidates as compared to age-matched control subjects: A potential marker of cognitive function for auditory information processing

OBJECTIVE

To evaluate magnetic resonance imaging (MRI)-based olfactory bulb (OB) volumes in cochlear implant (CI) candidates with sensorineural hearing loss as compared to age-matched control subjects with normal hearing.

METHODS

A total of 31 pediatric CI candidates (mean ± SD age: 7.0 ± 2.5 years, 51.6% were boys) with sensorineural hearing loss and 35 age-matched control subjects (mean ± SD age: 7.1 ± 2.5 years, 54.3% were boys) with normal hearing were included in this study. Data on demographic characteristics (age, gender) and right and left OB volume (mm³) on MRI using planimetric contouring method were recorded in patients and control groups.

RESULTS

Median (min-max) values for right OB volume (80(50-120) vs. 90(50-160) mm³, p = 0.006) and left OB volume (70(50-120) vs. 90(50-170) mm³, p = 0.007) were significantly lower in CI candidates vs. controls, regardless of the gender and age. No significant difference was noted between right and left OB volume in CI candidate and control groups. Hearing loss subgroups of CI candidates including hereditary familial (n = 8), hereditary non-familial (n = 14) and mixed syndromic (9) subgroups were also similar in terms of patient demographics and OB volumes. There was a tendency for having lower left OB volume (60(50-120) vs. 80(60-110) mm³) in girls vs. boys in the CI candidate group, along with a tendency for lower left and right OB volume in candidates vs. controls, particularly at age 11 (median 120 vs. 80 mm³ and 120 vs. 60 mm³, respectively). No significant correlation of age was noted with right and left OB volume overall and in the study groups.

CONCLUSION

In conclusion, our findings revealed lower left and right OB volumes in CI candidates compared to control subjects, regardless of age and gender, indicating the presence of baseline olfactory dysfunction in patients with hearing loss planned to undergo CI. Accordingly, MRI-based measurement of OB volume in the pre-surgical workup of CI candidates may serve as a marker of cognitive function enabling auditory information processing that may also correlate with post-operative CI outcomes.

Reliability of CIR-S using the subperiosteal pocket technique under 2 years of age

OBJECTIVE

It is aimed in this study to investigate the reliability of the cochlear implant receiver-stimulator (CIR-S) placement using unfixed subperiosteal tight pocket technique and the postoperative soft tissue changes that occur around the CIR-S, in toddlers under 2 years of age.

METHODS

Nonsyndromic toddlers with normal radiological findings and who were planned to have cochlear implantation were included in the study. Preoperative and postoperative complications, device migration, and postoperative soft tissue changes occurred around the CIR were analyzed using objective methods.

RESULTS

Twenty-six toddlers aged between 12 and 24 months who met the study criteria were followed up for a mean follow-up duration of 18 months. No intraoperative and postoperative surgical complications and device migration were observed in any of the cases included in the study.

CONCLUSION

It was concluded as a result of this study that cochlear implant receiver-stimulator placement using the subperiosteal pocket technique is reliable in toddlers under 2 years of age, provided that the small incision tight subperiostal pocket technique is performed meticulously without fixation and well drilling, and that device-protective changes occur in the tissues around the CIR-S over time with the use of the device and as the child skull develops.