{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:43:12Z","timestamp":1788788592761,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,1,6]],"date-time":"2019-01-06T00:00:00Z","timestamp":1546732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>There is no consensus on the necessary preoperative imaging in children being evaluated for cochlear implantation (CI). Dual\u2010imaging protocols that implement both magnetic resonance imaging (MRI) and high resolution computed tomography (HRCT) create diagnostic redundancy in the face of potentially unnecessary radiation and anaesthetic exposure. The objectives of the current study were to examine the efficacy of an MRI\u2010predominant with selective HRCT imaging protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The protocol was implemented over a 4\u2010year period, during which HRCT was obtained in addition to MRI only if specific risk factors on clinical assessment were identified or if imaging findings in need of further evaluation were detected on initial MRI evaluation. Retrospective review of operative reports and prospective review of imaging were performed; anesthetic exposure and costing information were also obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 240 patients who underwent assessment, seven (2.9%) had combined HRCT and MRI performed concurrently based on initial clinical assessment, 15 (6.3%) underwent HRCT based on imaging anomalies found on MRI, and MRI alone was ordered for the remaining 218 (90.1%). All patients were implanted without complication. Overall, radiation exposure, general anesthesia (GA), and healthcare costs were reduced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MRI alone can be used in the vast majority of cases for preoperative evaluation of pediatric CI candidates resulting in a significant reduction in healthcare costs, radiation, and GA exposure in children. The additional need for HRCT occurs in a small proportion and can be predicted up front on clinical assessment or on initial MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:2627\u20132633, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27666","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T03:40:09Z","timestamp":1546918809000},"page":"2627-2633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Efficacy of a selective imaging paradigm prior to pediatric cochlear implantation"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7140-6671","authenticated-orcid":false,"given":"Jennifer M.","family":"Siu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan I.","family":"Blaser","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging\u2013Head and Neck Surgery The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Archie's Cochlear Implant Laboratory The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Communication Disorders The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Sciences University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake C.","family":"Papsin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Archie's Cochlear Implant Laboratory The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Communication Disorders The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Cushing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Archie's Cochlear Implant Laboratory The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Communication Disorders The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2014.03.011"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200212000-00019"},{"key":"e_1_2_6_4_1","first-page":"115:1","article-title":"Cochlear implantation in children with anomalous cochleovestibular anatomy","author":"Papsin B","year":"2005","journal-title":"Laryngoscope"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000253285.40995.91"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000185049.61770.da"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2005.09.007"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(99)00112-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e3182263460"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-015-0819-6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.09.016"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25659"},{"key":"e_1_2_6_13_1","unstructured":"ParkesW BlaserS CushingS JamesA PB. 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