CT Head High-spatial resolution of CT head is insufficient in providing anatomic details of temporal bone needed for surgical planning prior to cochlear implantation. Accordingly, there is no evidence to support routine use of CT head for this indication. CTA Head There is no evidence to support routine use of CTA for surgical planning prior to cochlear implantation in patients with deafness. MRI Head and Internal Auditory Canal MRI may provide a complementary role to temporal bone CT in preoperative assessment of patients prior to cochlear implantation. Exquisite details of inner ear structures visible on high-resolution T2-weighted images can help in detecting abnormalities, such as cochlear malformations or cochlear nerve deficiency, that directly impact surgical approach [37,38]. In addition, MRI may reveal unexpected soft-tissue abnormalities, such as vestibular schwannomas that may impact the planned surgery [39]. MRA Head There is no evidence to support routine use of MRA for surgical planning prior to cochlear implantation in patients with deafness. MR Venography Head There is no evidence to support routine use of MRV for surgical planning prior to cochlear implantation in patients with deafness. Variant 6: Episodic vertigo with or without associated hearing loss or aural fullness (peripheral vertigo). Initial imaging. CT Temporal Bone CT of the temporal bone provides excellent delineation of the bony labyrinth and is helpful in detecting a number of pathologies resulting in peripheral vertigo. It is highly sensitive in detecting temporal bone fractures in patients with post-traumatic vertigo, assessing for superior semicircular canal dehiscence in patients with vertigo provoked by loud noises, and diagnosing erosions in the bony labyrinth from inflammatory or iatrogenic causes [5,8,9,14]. CT Head CT head provides insufficient details of the inner ear to be useful in patients with peripheral vertigo.
Hearing Loss and or Vertigo. CT Head High-spatial resolution of CT head is insufficient in providing anatomic details of temporal bone needed for surgical planning prior to cochlear implantation. Accordingly, there is no evidence to support routine use of CT head for this indication. CTA Head There is no evidence to support routine use of CTA for surgical planning prior to cochlear implantation in patients with deafness. MRI Head and Internal Auditory Canal MRI may provide a complementary role to temporal bone CT in preoperative assessment of patients prior to cochlear implantation. Exquisite details of inner ear structures visible on high-resolution T2-weighted images can help in detecting abnormalities, such as cochlear malformations or cochlear nerve deficiency, that directly impact surgical approach [37,38]. In addition, MRI may reveal unexpected soft-tissue abnormalities, such as vestibular schwannomas that may impact the planned surgery [39]. MRA Head There is no evidence to support routine use of MRA for surgical planning prior to cochlear implantation in patients with deafness. MR Venography Head There is no evidence to support routine use of MRV for surgical planning prior to cochlear implantation in patients with deafness. Variant 6: Episodic vertigo with or without associated hearing loss or aural fullness (peripheral vertigo). Initial imaging. CT Temporal Bone CT of the temporal bone provides excellent delineation of the bony labyrinth and is helpful in detecting a number of pathologies resulting in peripheral vertigo. It is highly sensitive in detecting temporal bone fractures in patients with post-traumatic vertigo, assessing for superior semicircular canal dehiscence in patients with vertigo provoked by loud noises, and diagnosing erosions in the bony labyrinth from inflammatory or iatrogenic causes [5,8,9,14]. CT Head CT head provides insufficient details of the inner ear to be useful in patients with peripheral vertigo.