Algin Oktay, Berçin Sami, Akgunduz Gokce, Turkbey Baris, Cetin Huseyin
Radiology Department, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey.
Emerg Radiol. 2012 Dec;19(6):557-60. doi: 10.1007/s10140-012-1050-3. Epub 2012 May 26.
Sensorineural hearing loss (SNHL) can develop after trauma and determination of its etiology is crucial for treatment planning. Computed tomography (CT) is the first-line imaging method in evaluation of trauma victims; however, its value is limited in visualization of perilymphatic fistula or in assessment of cochlear implant candidates. Herein, we present imaging findings of a patient with traumatic bilateral transverse fractures of temporal bones and resultant SNHL. This patient had a fistula between inner ear and subarachnoid space which was detected at non-contrast-enhanced MR cisternography (NCE-MRC) and contrast-enhanced MR cisternography (CE-MRC) scans. To the best of our knowledge, this is the first case in the literature. In conclusion, in patients with transverse fractures of temporal bone, in presence of otic capsule involvement at CT images, the inner ear structures and surrounding organs should be carefully evaluated via NCE-MRC. In case of a suspicion of a fistula, CE-MRC can help in early diagnosis and can also help to visualize the leakage location, which is of paramount importance for correct treatment and management of such cases.
感音神经性听力损失(SNHL)可在创伤后发生,确定其病因对于治疗方案的制定至关重要。计算机断层扫描(CT)是评估创伤患者的一线成像方法;然而,其在显示外淋巴瘘或评估人工耳蜗植入候选者方面的价值有限。在此,我们展示了一名患有双侧颞骨外伤性横行骨折并导致SNHL患者的影像学表现。该患者内耳与蛛网膜下腔之间存在瘘管,这在非增强磁共振脑池造影(NCE-MRC)和增强磁共振脑池造影(CE-MRC)扫描中被检测到。据我们所知,这是文献中的首例病例。总之,对于颞骨横行骨折的患者,若CT图像显示有内耳受累,应通过NCE-MRC仔细评估内耳结构和周围器官。若怀疑存在瘘管,CE-MRC有助于早期诊断,还能帮助显示渗漏位置,这对于此类病例的正确治疗和管理至关重要。