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Clinical Note |

Successful Cochlear Implantation in a Patient With Bilateral Thalamic Infarction

Ken Ito, MD; Rumi Ishida, MD; Yusuke Akamatsu, SLHT; Erika Ogata, SLHT; Takaharu Nito, MD
Arch Otolaryngol Head Neck Surg. 2007;133(2):192-193. doi:10.1001/archotol.133.2.192.
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The thalamus occupies four fifths of the diencephalon, and all afferent impulses except olfaction pass through the thalamus. Auditory impulses ascend through the cochlear nucleus, superior olivary complex, and inferior colliculus and then are transmitted through the medial geniculate body. Language disturbances, including aphasia, as well as dementia and emotional disorders, have been reported in patients with thalamic lesions (eg, infarction or thalamotomy).17 Because disorders in the central auditory pathway and severe psychiatric disorders have been regarded as contraindications for cochlear implantation (eg, this is explicitly written in the Japanese guidelines for cochlear implantation), one should be very cautious in determining the indication for cochlear implantation in profoundly deaf patients with thalamic disorders. In this report, to our knowledge, we demonstrate for the first time the successful cochlear implantation in a patient with bilateral thalamic infarction secondary to meningitis.

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T2-weighted magnetic resonance image showing infarction mainly of the bilateral medial regions of the thalamus (arrows). A indicates anterior; L, left; P, posterior; and R, right.

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