Radiology for cochlear implants

One fifth of patients selected for cochlear implants have such bony irregularities in the cochlear duct that full insertion of a multichannel electrode array is impossible. Three cases of cochlear deafness are presented where pre- and post-operative radiology played an important part in the management. Standard CT at 2 mm cuts is compared with ultra high resolution CT at 1 mm cuts. The pitfall of poor definition is that the inexperienced surgeon may find himself unexpectedly drilling out an obliterated cochlear duct. Sections 30 degrees caudal to Reid's infra orbito-meatal base line at 1 mm intervals give maximum information for minimum radiation. Plain films show the placement of individual platinum electrode contacts in relation to the spiral ‘frequency map’ of the cochlea. This is vital information for the audiologist who has to route specific frequencies to specific sites within the ear for a good hearing result.