Meriot P, Marsot-Dupuch K
Service d'Imagerie Médicale du Pr Bellet, CHU de Brest, Hôpital de la Cavale Blanche, Brest.
J Radiol. 1999 Dec;80(12 Suppl):1780-7.
Tinnitus, hearing loss, and more rarely disequilibrium are common sequela of temporal bone trauma. Hemotympanum may cause a transient and immediate conductive hearing loss. HRCT depicts ossicular dislocation (most frequently incus), producing a long-term conductive hearing loss. Labyrinthine trauma causing neurosensory hearing loss or/and acute vertigo may be depicted by MRI, showing an abnormal non-enhancing high signal T1 of the membranous labyrinthine fluid. MRI also may show low signal T1 and T2 fibrotic areas of the membranous labyrinth, especially of interest if cochlear implant surgery is planned. Perilymphatic fistulas are to be searched in case of fluctuant hearing loss. Both HRCT and MRI may show window damage: filling of the tympanic recess, rupture of the window membrane, intra-vestibular luxation of the stapes, or occasionally pneumolabyrinth.
耳鸣、听力损失,较少见的还有平衡失调,是颞骨创伤的常见后遗症。血鼓室可导致短暂且即刻的传导性听力损失。高分辨率计算机断层扫描(HRCT)显示听骨脱位(最常见的是砧骨),导致长期传导性听力损失。导致感音神经性听力损失或/和急性眩晕的迷路创伤可通过磁共振成像(MRI)显示,表现为膜迷路内液体在T1加权像上呈异常的无强化高信号。MRI还可能显示膜迷路的T1和T2加权像上的低信号纤维化区域,如果计划进行人工耳蜗植入手术,这一点尤其值得关注。在听力波动的情况下,应排查外淋巴瘘。HRCT和MRI均可显示中耳结构破坏:鼓室隐窝充盈、鼓膜破裂、镫骨前庭内脱位,或偶尔出现气迷路。