Positive predictive value for diffusion-weighted magnetic resonance imaging in pediatric cholesteatoma: A retrospective study.

OBJECTIVES: The aims of this study were first to calculate the Positive Predictive Value (PPV) of DW-MRI to detect cholesteatoma and then to analyze false positives. METHODS: All temporal bone MRI with DWI sequences performed in our pediatric university hospital between 2005 and 2015 were included retrospectively. 46 patients with a cholesteatoma diagnosis on the MRI report and who underwent surgery were studied. RESULTS: The number of DW-MRI for identification of cholesteatoma has grown in ten years. We calculated an 89% Positive Predictive Value. DW-MRI sensitivities were 100.0% and 70.7% for respectively keratin and squamous epithelium. CONCLUSION: DW-MRI hypersignal is not synonymous of cholesteatoma diagnosis. Indeed, this diagnosis relies on the importance of a proper otoscopic examination, a suggestive medical history, CT scan data and analysis of other MRI sequences, including T1-weighted sequence, to rule out other etiologies of middle ear DW-MRI hypersignal.

Pediatric Evaluation of the ClearVoice™ Speech Enhancement Algorithm in Everyday Life.

ClearVoice™ enables Advanced Bionics cochlear implant users to improve their speech understanding in difficult listening environments, without compromising performance in quiet situations. The aim of the study was to evaluate the benefits of ClearVoice in children. Children between six and fourteen years of age randomly tested two modalities of ClearVoice for one month each. The baseline program, HiRes 120™, and both ClearVoice programs were evaluated with a sentence test in quiet and noise. Parents and teachers completed a questionnaire related to everyday noisy situations. The switchover to ClearVoice was uneventful for both modalities. Adjustments to thresholds and comfort levels were required. Seven out of the nine children preferred a ClearVoice program. No impact of ClearVoice on performance in quiet was observed and both modalities of ClearVoice improved speech understanding in noise compared to the baseline program, significantly with ClearVoice high. Positive outcomes were obtained from the questionnaires and discussions with parents and children. This study showed that children benefited from using ClearVoice in their daily life. There was a clear trend towards improved speech understanding in noise with ClearVoice, without affecting performance in quiet; therefore ClearVoice can be used by children all day, without having to change programs.