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. 2020 Aug 12:11:759.
doi: 10.3389/fneur.2020.00759. eCollection 2020.

MRI Observation After Intralabyrinthine and Vestibular Schwannoma Resection and Cochlear Implantation

Holger Sudhoff  1 , Hans B Gehl  2 , Lars U Scholtz  1 , Ingo Todt  1
Affiliations

MRI Observation After Intralabyrinthine and Vestibular Schwannoma Resection and Cochlear Implantation

Holger Sudhoff et al. Front Neurol. .

Abstract

Objective: MRI observation is part of the regular follow-up after vestibular schwannoma (VS) or intralabyrinthine schwannoma (ILS) resection. Because cochlear implantation (CI) after resection is part of the audiological rehabilitation process, the magnet resonance imaging (MRI) behavior of CI systems needs to be considered. In light of recent developments in MRI artifact positioning and pain prevention, this study evaluates reproducible MRI observations after tumor resection and CI surgery as part of follow-up. Methods: In a retrospective study, we evaluated 9 patients with a T1 KM, T2 sequence MRI observation, and cone beam computed tomography (CBCT) after ILS/VS resection and CI. In all but one case, a CI with a diametrically bipolar magnet and a receiver positioned 8-9 cm behind the external auditory canal was performed. Results: In all but one case, MRI observation allowed for a pain-free visual assessment of the intralabyrinthine and internal auditory canal (IAC) regions. In one case, a painful dislodgement of the receiver magnet occurred. Conclusion: MRI follow-up after ILS and VS resection and CI is reproducibly possible. Implant choice and positioning should be considered before implantation to allow for a pain-free visual assessment afterward. This finding allows for the first time a widening of the indication into this patient group.

Keywords: MRI; cochlear implant; intralabyrinthine schwannoma; tumor follow up; vestibular schwannoma.

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Figures

Figure 1
Figure 1
An exemplary ILS tumor (T1, KM), coronal. Arrow indicates tumor.
Figure 2
Figure 2
The ILS region with a T2 TSE sequence after CI, axial. Visual assessment of cochlea and vestibulum. Circle indicates region of interest.
Figure 3
Figure 3
The exemplary VS before resection (T2 TSE). Arrow indicates tumor.
Figure 4
Figure 4
T2 TSE after CI, axial. Visual assessment of IAC. Circle indicates region of interest.
Figure 5
Figure 5
T2 TSE after CI, coronal. Visual assessment of cochlea. Circle indicates region of interest.
Figure 6
Figure 6
Exemplary recommended position of the implant with a nasion–external auditory canal–magnet angle of 140° and a distance of 9 cm.
See this image and copyright information in PMC

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