Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilian University, Munich, Germany.
Int J Audiol. 2013 Jul;52(7):495-9. doi: 10.3109/14992027.2013.786191. Epub 2013 May 29.
To evaluate the prevalence of labyrinthine ossification, and especially cochlear ossification, in a cohort of patients with unilateral sudden deafness or severe sensorineural hearing loss.
Retrospective data collection.
Sixty-four consecutive patients with unilateral sudden deafness or severe sensorineural hearing loss and either high-resolution CT (HRCT) of the temporal bone (isotropic spatial resolution ≤ 0.8 mm; n = 18) or high resolution CISS MRI (isotropic spatial resolution ≤ 1 mm; n = 55) were included. Nine patients underwent both imaging modalities. A standardized reading regarding labyrinthine ossifications was performed by an experienced head and neck radiologist blinded to clinical symptoms.
Radiologic signs of cochlear ossification were present in 14 patients (12 CT and 2 MRI). Eight patients showed unilateral and six patients bilateral signs of cochlear ossification. In all except one of the unilateral cases, the deafened ear was affected.
Signs of cochlear ossification were found in an unexpectedly high rate (14/64, 22%) of patients with acute deafness. The data suggest HRCT of the temporal bone to be more sensitive to detect labyrinthine ossification than MRI. HRCT of the temporal bone should therefore be considered in patients with impaired recovery of acute deafness to exclude cochlear ossification; if present, and, in cases of early signs, the patient should be evaluated further to facilitate early cochlear implantation before progression impedes electrode insertion, reflecting latest developments considering cochlea implants for single-sided deafness to be effective.
评估单侧突发性聋或重度感音神经性聋患者中迷路骨化,尤其是耳蜗骨化的发生率。
回顾性数据收集。
64 例单侧突发性聋或重度感音神经性聋患者,其中高分辨率 CT(颞骨各向同性空间分辨率≤0.8mm;n=18)或高分辨率 CISS MRI(各向同性空间分辨率≤1mm;n=55)连续患者。9 例患者同时进行了两种影像学检查。由一位经验丰富的头颈部放射科医生对迷路骨化的影像学表现进行标准化阅读,该医生对临床症状不知情。
14 例患者(12 例 CT,2 例 MRI)存在耳蜗骨化的放射学征象。8 例患者单侧出现耳蜗骨化征象,6 例患者双侧出现耳蜗骨化征象。除了 1 例单侧病例外,其余所有病例均为耳聋耳受累。
在急性耳聋患者中,迷路骨化的影像学表现发生率出乎意料地高(14/64,22%)。数据表明,HRCT 对迷路骨化的检测比 MRI 更敏感。因此,对于急性耳聋恢复不良的患者,应考虑进行颞骨 HRCT 以排除耳蜗骨化;如果存在,并且存在早期迹象,应进一步评估患者,以便在进展阻碍电极插入之前尽早进行耳蜗植入,这反映了最新进展,考虑到单侧重度耳聋的人工耳蜗植入是有效的。