Haktanir Alpay, Yücedağ Fatih, Kaçar Emre, Ulu Sahin, Gültekin Mehmet Ali, Ünlü Ebru, Bucak Abdülkadir, Ayçiçek Abdullah
Department of Radiology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
J Craniofac Surg. 2013 Jul;24(4):1153-5. doi: 10.1097/SCS.0b013e318293f840.
We aimed to examine the prevalence of cerebellar tonsil ectopia and Chiari 1 malformation in sensorineural hearing loss (SHL) that has, to the best of our knowledge, not been studied previously. Magnetic resonance imaging records of 166 subjects with SHL and 50 controls without known otologic disturbances were included in the study. A tonsils descent more than 2 mm was assumed as cerebellar ectopia, and a descent equal to or more than 5 mm was assumed as Chiari 1 malformation. A tonsil descent group was also formed by summation of both groups. Transverse diameters of bilateral intracranial vertebral arteries and transverse sinuses were also measured, and all parameters were analyzed using appropriate statistics. A significant difference of frequencies of Chiari 1, ectopia, and tonsil descent was detected between patients and controls. In comparison of cerebellar ectopia and Chiari 1 groups, SHL did not show any significant difference. The left lateral sinus diameter showed positive correlation with tonsil descent. There was no significant correlation for the diameters of other vessels. A powerful correlation was detected between SHL and age. In addition, right and vertebral artery diameters showed positive correlations with age. Chiari 1 malformation and cerebellar ectopia showed an association with SHL. These patients should also be evaluated for otologic disturbances. Further high-resolution magnetic resonance imaging studies to explain the exact cause of this currently unknown association seems required.
据我们所知,此前尚未有研究对感音神经性听力损失(SHL)患者中小脑扁桃体下疝及Chiari 1畸形的患病率进行过研究,我们旨在对此展开调查。本研究纳入了166例SHL患者的磁共振成像记录以及50例无已知耳科疾病的对照者的记录。扁桃体下移超过2mm被视为小脑下疝,下移等于或超过5mm被视为Chiari 1畸形。两组数据相加还形成了一个扁桃体下移组。同时测量了双侧颅内椎动脉及横窦的横径,并使用适当的统计学方法对所有参数进行分析。患者与对照者之间在Chiari 1畸形、下疝及扁桃体下移的频率上存在显著差异。在小脑下疝组与Chiari 1畸形组的比较中,SHL未显示出任何显著差异。左侧横窦直径与扁桃体下移呈正相关。其他血管直径之间无显著相关性。SHL与年龄之间存在强相关性。此外,右侧及椎动脉直径与年龄呈正相关。Chiari 1畸形及小脑下疝与SHL存在关联。这些患者还应接受耳科疾病评估。似乎需要进一步开展高分辨率磁共振成像研究以解释这种目前尚不清楚的关联的确切原因。