CT and MR imaging of the inner ear and brain in children with congenital sensorineural hearing loss.

Imaging plays an important role in the evaluation of congenital sensorineural hearing loss. In children who are candidates for cochlear implantation surgery, it provides vital preoperative information about the inner ear, the vestibulocochlear nerve, and the brain. High-resolution computed tomography (CT) and magnetic resonance (MR) imaging provide excellent delineation of the intricate anatomy of the inner ear: CT depicts the minute details of osseous structures, and MR imaging allows visualization of the fluid-filled spaces and the vestibulocochlear nerve. Together, these complementary modalities can aid decision making about the best management strategy by facilitating the identification and characterization of inner ear malformations and any associated neurologic abnormalities. It is important that the radiologist be familiar with the key imaging features when interpreting CT and MR images obtained in this patient group. A broad spectrum of inner ear malformations have been described and linked to developmental insults at different stages of embryogenesis, and various systems have been proposed for classifying them. In this article, these malformations are described by using classification systems used by otolaryngologists for ease of interpretation. The relevant normal anatomy and development of the inner ear are briefly surveyed, standard imaging protocols for studying the inner ear are reviewed, and the imaging appearances of frequently observed inner ear malformations are described and illustrated. The impact of the identification of these malformations and commonly associated brain abnormalities on clinical management and prognosis also is discussed.

Classification of nasal septal deviations-Relation to sinonasal pathology.

The relationship between sinonasal disease and septal deriations is well known, albeit vaguely. There was no serious attempt to classify deviations except calling them mild deviations, gross deviations, spur; high deviations, etc. The airflow changes in these deviations, which lead to mucosal changes predisposing to polyps or infection have not been documented clearly. In this study we made a classification of septal deformities by modifying the classification described by Mladina in 1987. This classification has been applied to 100 consecutive cases who have been advised nasal surgery and 100 normal individuals who did not have any nasal symptoms. All patients had CT scan of PNS and their CT findings were studied in relation to the type of deviation. This paper presents an analysis of the incidence of various types of deviations in patients and controls and the relationship of different deformities to the sinus pathology.