Preoperative cerebral magnetic resonance imaging and white matter changes in pediatric cochlear implant recipients

Introduction: Preoperative magnetic resonance imaging (MRI) can yield valuable information regarding the status of the inner ear in pediatric cochlear implant (CI) candidates. Incidentally, cerebral white matter changes are at times noted on these MRI scans. They may indicate post-infectious/postinflammatory changes or progressive neurodegenerative processes. Objective: To evaluate the clinical significance of cerebral white matter changes in pediatric CI patients. Methods: Retrospective chart review of pediatric CI recipients with preoperative MRI between March 2004 and January 2009 was performed. MRI reports along with postoperative audiology and speech and language outcomes were assessed. Results: Fifty-seven patients were included in the study. There were 29 females and 28 males. Mean age was 58 months (range of 12-194 months). Abnormal MRI with varying degrees of white matter changes was noted in 10 (18%) children. Neurological assessments did not reveal any serious central nervous system diseases. Two of the 10 patients demonstrated significant delays and difficulties with postoperative CI performance. Conclusions: Cerebral white matter abnormalities are not uncommon incidental findings in preoperative MRI scans in pediatric CI candidates. These changes may reflect remote or active pathology which may require neurological assessment. The significance of these findings is still uncertain and should be better clarified as we study more patients.