Dumas G, Charachon R, Vasdev A, Mouret P, Richard J
Clinique ORL, CHU, Grenoble.
Ann Otolaryngol Chir Cervicofac. 1991;108(1):1-12.
17 new cases of malformation of the bony labyrinth detected radiologically (tomography, CT) and associated with perceptive or composite deafness are reported. 2 cases discovered in spontaneous or traumatic recurrent meningitis are described, as well as 1 case discovered after the occurrence of total deafness following stapedial surgery. The malformations were unilateral in 7 cases, bilateral in 10. Deafness was of the composite type in 6 cases. An associated malformation of the middle or external ear was noted in 4 cases. 5 cases were included in a context of multiple malformations, including 1 case of otobranchiorenal syndrome, 1 case of Apert's syndrome and 3 cases of craniostenosis. Referring to the classification given by Mrs Vignaud and Jardin, we have encountered 1 case of stage I malformation, 9 cases of stage II, pseudo-Mondini malformation, 1 case of stage III or true Mondini malformation, 1 case of stage IV malformation, 3 cases of malformation of the aqueduct of the vestibule, ie. stage V. We have also encountered 2 isolate cases of stenosis of the internal auditory canal. On the basis of these cases, we report a few physiopathogenetic hypotheses and various classifications currently described in the literature. We also list the various associated external and middle ear malformations and the multiple-malformation syndromes that are commonly described. Stress is laid on the fact that these malformations often go undetected in congenital deafness, as well as on the usual course of these types of deafness for which there is no medical or surgical treatment.
报告了17例经放射学检查(体层摄影、CT)发现的骨迷路畸形病例,这些病例伴有感音性或混合性耳聋。描述了2例在自发性或创伤性复发性脑膜炎中发现的病例,以及1例在镫骨手术后出现全聋后发现的病例。畸形为单侧的有7例,双侧的有10例。耳聋为混合性类型的有6例。4例发现伴有中耳或外耳畸形。5例属于多发畸形情况,包括1例耳-鳃-肾综合征、1例阿佩尔综合征和3例颅缝早闭。参照维尼奥德夫人和雅尔丹给出的分类,我们遇到了1例I期畸形、9例II期假性蒙迪尼畸形、1例III期或真性蒙迪尼畸形、1例IV期畸形、3例前庭导水管畸形即V期畸形。我们还遇到了2例孤立的内耳道狭窄病例。基于这些病例,我们报告了一些病理生理发病机制假说以及目前文献中描述的各种分类。我们还列出了各种相关的外耳和中耳畸形以及常见的多发畸形综合征。强调了这些畸形在先天性耳聋中常常未被发现这一事实,以及这类耳聋通常的病程,对此尚无医学或外科治疗方法。