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细菌性脑膜炎后重度听力损失患者的耳蜗骨化

Cochlear ossification in patients with profound hearing loss following bacterial meningitis.

作者信息

Caye-Thomasen Per, Dam Mikkel Seidelin, Omland Silje Haukali, Mantoni Margit

机构信息

Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Rigshospitalet/Gentofte, Copenhagen, Denmark.

出版信息

Acta Otolaryngol. 2012 Jul;132(7):720-5. doi: 10.3109/00016489.2012.656323. Epub 2012 Apr 12.

Abstract

CONCLUSION

Cochlear ossification following bacterial meningitis is related to causative pathogen, but not age at disease or time point of evaluation. However, progression may occur over time, especially in case of primary signs of ossification.

OBJECTIVE

To investigate the occurrence and degree of cochlear ossification on CT and MRI in patients with bilateral profound hearing loss following bacterial meningitis, in relation to causative pathogen, age at disease, and time point of evaluation. Progression of ossification in cases that underwent more than one scan was evaluated.

METHODS

In the period 1982-2008, 47 cochlear implantations were performed in 34 consecutive candidates suffering from bilateral profound hearing loss following bacterial meningitis. A retrospective review of patient files and preoperative CT and MR images was performed.

RESULTS

Cochlear ossification was observed in 35% of patients and 26% of ears on CT. The corresponding values for MRI were 44 and 30% (difference not significant). Streptococcus pneumoniae infection caused ossification more frequently than Neisseria meningitidis. No difference was found between pediatric and adult cases, and the occurrence of ossification was not related to the time point of evaluation. Signs of progressive ossification were found in cases with two CT scans, especially if ossification was present at the first scan.

摘要

结论

细菌性脑膜炎后的蜗管骨化与致病病原体有关,但与发病年龄或评估时间点无关。然而,随着时间推移可能会发生进展,尤其是在存在骨化初步迹象的情况下。

目的

研究细菌性脑膜炎后双侧重度听力损失患者在CT和MRI上蜗管骨化的发生率和程度,及其与致病病原体、发病年龄和评估时间点的关系。对接受多次扫描的病例评估骨化进展情况。

方法

在1982年至2008年期间,对34例因细菌性脑膜炎导致双侧重度听力损失的连续候选者进行了47次人工耳蜗植入手术。对患者病历以及术前CT和MR图像进行回顾性分析。

结果

CT检查发现35%的患者和26%的耳存在蜗管骨化。MRI的相应数值分别为44%和30%(差异无统计学意义)。肺炎链球菌感染比脑膜炎奈瑟菌更易导致骨化。儿童和成人病例之间未发现差异,骨化的发生与评估时间点无关。在进行两次CT扫描的病例中发现了骨化进展的迹象,尤其是在首次扫描时就存在骨化的情况下。

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