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. 2025 Nov 21;15(6):162.
doi: 10.3390/audiolres15060162.

A Concept for MRI-Based Cholesteatoma Detection in Cochlear Implant Recipients

Lukas Woltersdorf  1 , Rayoung Kim  1 , Alexander Rempen  1 , Christoph Pfeiffer  1 , Lars-Uwe Scholtz  1 , Christiane Schimmack  2 , Daniela Eickenjäger  2 , Rüdiger Steinbach  2 , Ingo Todt  1   3
Affiliations

A Concept for MRI-Based Cholesteatoma Detection in Cochlear Implant Recipients

Lukas Woltersdorf et al. Audiol Res. .

Abstract

Introduction: Cochlear implantation is the treatment of choice for severe hearing loss and deafness. Cholesteatomas can cause this deafness. A frequently used procedure in the course of surgical rehabilitation is a subtotal petrosectomy combined with a cochlear implant. The clinical follow-up of residual cholesteatomas is related to the blind sac closure difficult. Cholesteatoma MRI sequence-related CI magnet artefacts make follow-up challenging. Recent developments in combining cochlear implants and necessary MRI examinations enable the assessment of the internal auditory canal and cochlea. The study aimed to develop a procedure for detecting cholesteatomas in patients with cochlear implants using magnetic resonance imaging (MRI).

Methods: Ex vivo MRI examinations were performed on five volunteers with fixed cochlear implants (Medel Synchrony) and swim caps. MRI examinations were performed at 1.5 T and 3 T using EPI, HASTE, and RESOLVE sequences (Siemens). The position of the implant was 12 cm distal to the external auditory canal, with anteversional head position of the volunteers in the MRI.

Results: Due to artefact effects, assessment of the ipsilateral and contralateral mastoid is not possible with EPI sequences and a cochlear implant. The combination of cholesteatoma-detecting MARS sequences (HASTE, RESOLVE), a distal implant position, and a specific head position allows the assessment of the ipsilateral mastoid.

Conclusions: 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.

Keywords: CI; MRI; cholesteatoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Exemplary cholesteatoma of a left mastoid cavity scan with HASTE at 1.5 T.
Figure 2
Figure 2
Exemplary scan with an EPI2D sequence at 3T in a coronal (a) and axial plane (b).
Figure 3
Figure 3
Exemplary scan with a RESOLVE sequence at 3 T in a coronal (a) and axial (b) plane.
Figure 4
Figure 4
Exemplary scan with HASTE sequence at 1.5 T in a coronal (a) and axial (b) plane.
Figure 5
Figure 5
Exemplary scan with HASTE sequence at 1.5 T in a coronal (a) and axial (b) plane with an EAC distance of 7 cm, without a chin-to-chest position of the head in the scanner.
See this image and copyright information in PMC

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