Preoperative Imaging for Cochlear Implantation: A Global Consensus

Objective: Preoperative imaging is vital for cochlear implant surgeries, aiding diagnosis, and surgical planning. This study evaluated global practices and the value of preoperative imaging through an international survey. Methods: A cross-sectional survey was conducted among international cochlear implantation experts using a 112-item questionnaire. The study explored imaging modalities, anatomical targets, evaluated parameters, and different imaging approaches' perceived value and risks. Participants were recruited from a global consortium of otolaryngology, otology, neurotology, and cochlear implant surgery professionals. Results: Thirty-nine practitioners from 36 centers in 16 countries completed the survey (95.1% response rate). All used computed tomography (CT) and magnetic resonance imaging (MRI) for preoperative evaluation; MRI was deemed more valuable for diagnosis and candidacy assessment, while CT was preferred for surgical planning. Nearly half utilized additional imaging modalities, with functional MRI being the most common (20.5%). Additionally, 79.5% of respondents reported using image-based surgical planning software. Discussion: Results show a universal reliance on CT and MRI for cochlear implant evaluations, with MRI aiding diagnosis and CT focusing on surgical planning. Advanced imaging techniques may emerge in specific clinical cases. Implications for Practice: Modern imaging practices and their potential changes can enhance protocol development and improve preoperative evaluations, ultimately boosting patient safety and outcomes in cochlear implantation.