Kim Minbum, Kim Jinna, Kim Sung Huhn, Kim Sang Cheol, Jeon Ju Hyun, Lee Won Sang, Kim Un-Kyung, Kim Hee Nam, Choi Jae Young
Department of Otology, Hana ENT Hospital, Seoul, South Korea.
Int J Pediatr Otorhinolaryngol. 2011 Dec;75(12):1538-44. doi: 10.1016/j.ijporl.2011.09.002. Epub 2011 Oct 2.
Most of the patients with enlarged vestibular aqueduct (EVA) experience sudden hearing deterioration, but the exact mechanism is unclear. We analyzed magnetic resonance (MR) images and the cellular components of endolymph obtained from the endolymphatic sac in patients with EVA, in order to demonstrate the cause of sudden hearing loss.
A total of 25 patients (50 ears) with EVA, who had severe to profound hearing loss, were included in this retrospective clinical study. MR examinations were performed by a 3.0-T MR system using an 8-channel sensitivity-encoding head coil. We analyzed endolymphatic fluid harvested from the endolymphatic sac during cochlear implantations in four patients.
The area of low signal intensity in the endolymphatic sac was observed on T2-weighted MR images for 15 of 50 ears. This area was observed more frequently in patients who experienced recent sudden hearing loss (10/12, 83%) than those with stable hearing (5/38, 13%)(Fisher's exact test, p<0.001). In addition, this area showed high signal intensity on fluid attenuated inversion recovery images. Cytologic analysis of the aspirated endolymph from the endolymphatic sac in the patients with this area revealed many erythrocytes.
Our data suggests that hemorrhage in the endolymphatic sac could be a cause of sudden hearing deterioration in patients with EVA.
大多数大前庭导水管（EVA）患者会突然出现听力下降，但其确切机制尚不清楚。我们分析了EVA患者的磁共振（MR）图像以及从内淋巴囊获取的内淋巴的细胞成分，以阐明突然听力损失的原因。
本回顾性临床研究纳入了25例（50耳）患有严重至极重度听力损失的EVA患者。使用8通道灵敏度编码头部线圈的3.0-T MR系统进行MR检查。我们分析了4例患者在人工耳蜗植入期间从内淋巴囊采集的内淋巴液。
在50耳中的15耳的T2加权MR图像上观察到内淋巴囊低信号强度区域。与听力稳定的患者（5/38，13%）相比，近期突然听力损失的患者（10/12，83%）更频繁地观察到该区域（Fisher精确检验，p<0.001）。此外，该区域在液体衰减反转恢复图像上显示高信号强度。对该区域患者内淋巴囊吸出的内淋巴进行细胞学分析发现许多红细胞。
我们的数据表明，内淋巴囊出血可能是EVA患者突然听力下降的原因。
