The role of temporal bone imaging in cochlear implants

Temporal bone imaging is an important component of pre- and postoperative care of cochlear implant patients. It is an essential aspect of patient selection and can be a powerful tool for enhancing implant performance. Preoperative examinations with high-resolution computed tomography reliably detect osteogenic, obi iterative, and neurodegenerative processes that may compromise implant surgery or device use. Magnetic resonance imaging is less routinely used preoperatively, but it can provide valuable first-order estimates of auditory nerve preservation. Intraoperative plain films are used to verify the intracochlear position of the implant. Device failures and surgical complications are generally investigated with computed tomography and magnetic resonance imaging. Significant improvements in the speed and accessibility of high-resolution three-dimensional reconstructions have increased their use at all implant evaluation stages. Preoperatively, reconstructions provide realistic surgical views of middle and inner ear anatomy; postoperatively, they provide insights into tissue-electrode relationships that are important for optimizing encoding strategies.