Propst Evan J, Blaser Susan, Gordon Karen A, Harrison Robert V, Papsin Blake C
Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Laryngoscope. 2005 Oct;115(10):1855-62. doi: 10.1097/01.mlg.0000177032.98386.20.
OBJECTIVES/HYPOTHESIS: To describe temporal bone findings using visual inspection and direct measurement on computerized tomography (CT) in individuals with branchio-oto-renal syndrome (BOR). We ask if it is possible for the untrained observer to use a battery of CT observations as a tool in the overall evaluation of the BOR phenotype.
Retrospective evaluation of CT findings in individuals with a clinical diagnosis of BOR based on criteria derived from genotype-phenotype analyses.
Prospective measurement of temporal bone CT imaging in 21 individuals (42 ears) with BOR and 21 normally hearing controls (21 ears) was performed. Thirty-nine aspects of each temporal bone were evaluated: 17 by direct measurement, 5 computed from direct measurement, and 17 by visual inspection. Thirty-eight recordings from each ear were made on axial section and 1 was made on coronal section.
Statistically significant differences were found between BOR and control groups in 30 of 39 categories (76.9%). The most common and easily identifiable characteristics of BOR by visual inspection were 1) hypoplastic apical turn of the cochlea, 2) facial nerve deviated to the medial side of the cochlea, 3) funnel-shaped internal auditory canal, and 4) patulous eustachian tube. The embryological origin of temporal bone anomalies in BOR are described.
CT evaluation of the temporal bone, when properly investigated, should be used as an important tool in the overall evaluation of the BOR phenotype.
目的/假设:使用计算机断层扫描(CT)对鳃-耳-肾综合征(BOR)患者进行颞骨检查并直接测量,以描述颞骨的检查结果。我们探讨未经训练的观察者是否能够使用一系列CT观察结果作为评估BOR表型的整体工具。
基于基因型-表型分析标准,对临床诊断为BOR的患者的CT检查结果进行回顾性评估。
对21例(42耳)BOR患者和21例听力正常的对照者(21耳)进行颞骨CT成像的前瞻性测量。对每侧颞骨的39个方面进行评估:17项通过直接测量,5项根据直接测量计算得出,17项通过视觉检查。每侧耳在轴位进行38项记录,在冠状位进行1项记录。
在39个类别中的30个(76.9%),BOR组与对照组之间存在统计学上的显著差异。通过视觉检查发现,BOR最常见且易于识别的特征为:1)耳蜗顶转发育不全;2)面神经向耳蜗内侧偏移;3)内耳道呈漏斗状;4)咽鼓管扩张。本文描述了BOR中颞骨异常的胚胎学起源。
对颞骨进行适当的CT评估,应作为评估BOR表型的重要工具。