Purpose
Cochlear implantation is the method of choice in treatment of bilateral severe to profound sensorineural hearing loss.
Inner ear malformations are found in 10-30% of patients with congenital sensorineural deafness on HRCT temporal bone[1].
The most widely accepted Sennaroglu classification is based on embryological development and pathogenesis[2].
The drawbacks of this classification are-
Intermediate forms are not clarified
Various types of incomplete partition and cochlear hypoplasia differs only by cochlear size which at present is not defined in any literature for malformed cochlea
Exhaustive and...
Methods and materials
Patient population:
In this prospective study, 56 children(ages 0-7years, mean age 3) with bilateral severe to profound sensorineural hearing loss in audiological test and inner ear anomaly on HRCT temporal bone were evaluated from July 2017 to Aug 2019.
Exclusion criteria were: absent/hypoplastic cochlear nerve, normal inner ear anatomy and mental retardation.
Data acquisition:
All studies were performed on 128 slice MDCT(Philips Ingenuity) and using head coil with patient in neutral supine position. Light sedation was used in all patients. An HRCT protocol consisting of...
Results
Cochleovestibular malformations:
Our study included 17 SMS type I anomaly,23 SMS type II anomaly, 14 SMS type III anomaly and 2 SMS type IV anomaly[Figure 2-7].
Inter-observer agreement for interpreting malformations by SMS classification(kappa 0.873) was almost perfect. Inter-observer agreement for interpretation by Sennaroglu classification(kappa 0.854) was also almost perfect.
The intraoperative complication and electrode type were easily decided according to SMS types[Table 1].
Prognosis
Friedman test: Age adjusted mean scores did not show any significant difference between children with SMS type I and II...
Conclusion
The purpose of this study was to compare the most widely used Sennaroglu classification with the recent clinically oriented SMS classification for cochleovestibular malformations.
In conclusion, SMS classification is easier to use and remember providing consistency in reporting, is clinically oriented, helps in deciding surgical approach and electrode type, predicts complications and prognosis and is thus better than Sennaroglu classification.
Personal information and conflict of interest
S. Agarwal; Jaipur/IN - nothing to disclose A. Prakash; Jaipur/IN - nothing to disclose M. Grover; Jaipur/IN - nothing to disclose
References
1)Jackler RK, Luxford WM, House WF. (1987)Congenital malformations of the inner ear: a classification based on embryogenesis. Laryngoscope 97:2–14
2)Sennaroglu L, Bajin MD. (2017)Classification and current management of inner ear malformations. Balkan Med J 34:397–411
3)Grover M, Sharma S, Preetam C et al. (2019)New SMS classification of cochleovestibular malformation and its impact on decision-making. J Laryngol Otol;133(5), 368-375