Marcus Sonya, Whitlow Christopher T, Koonce James, Zapadka Michael E, Chen Michael Y, Williams Daniel W, Lewis Meagan, Evans Adele K
New York University Langone Medical Center, Department of Otolaryngology, 550 First Avenue, NBB 5E5, New York, NY 10016, United States.
Department of Radiology, Wake Forest™ School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.
Int J Pediatr Otorhinolaryngol. 2014 Feb;78(2):268-71. doi: 10.1016/j.ijporl.2013.11.020. Epub 2013 Nov 25.
Prior studies have associated gross inner ear abnormalities with pediatric sensorineural hearing loss (SNHL) using computed tomography (CT). No studies to date have specifically investigated morphologic inner ear abnormalities involving the contralateral unaffected ear in patients with unilateral SNHL. The purpose of this study is to evaluate contralateral inner ear structures of subjects with unilateral SNHL but no grossly abnormal findings on CT.
IRB-approved retrospective analysis of pediatric temporal bone CT scans. 97 temporal bone CT scans, previously interpreted as "normal" based upon previously accepted guidelines by board certified neuroradiologists, were assessed using 12 measurements of the semicircular canals, cochlea and vestibule. The control-group consisted of 72 "normal" temporal bone CTs with underlying SNHL in the subject excluded. The study-group consisted of 25 normal-hearing contralateral temporal bones in subjects with unilateral SNHL. Multivariate analysis of covariance (MANCOVA) was then conducted to evaluate for differences between the study and control group.
Cochlea basal turn lumen width was significantly greater in magnitude and central lucency of the lateral semicircular canal bony island was significantly lower in density for audiometrically normal ears of subjects with unilateral SNHL compared to controls.
Abnormalities of the inner ear were present in the contralateral audiometrically normal ears of subjects with unilateral SNHL. These data suggest that patients with unilateral SNHL may have a more pervasive disease process that results in abnormalities of both ears. The findings of a cochlea basal turn lumen width disparity >5% from "normal" and/or a lateral semicircular canal bony island central lucency disparity of >5% from "normal" may indicate inherent risk to the contralateral unaffected ear in pediatric patients with unilateral sensorineural hearing loss.
先前的研究利用计算机断层扫描（CT）将严重的内耳异常与小儿感音神经性听力损失（SNHL）联系起来。迄今为止，尚无研究专门调查单侧SNHL患者对侧未受影响耳的形态学内耳异常。本研究的目的是评估单侧SNHL但CT上无明显异常发现的受试者的对侧内耳结构。
经机构审查委员会批准，对小儿颞骨CT扫描进行回顾性分析。根据经董事会认证的神经放射科医生先前接受的指南，97例先前被解读为“正常”的颞骨CT扫描，使用对半规管、耳蜗和前庭的12项测量进行评估。对照组由72例“正常”颞骨CT组成，排除了受试者存在潜在SNHL的情况。研究组由25例单侧SNHL受试者的听力正常的对侧颞骨组成。然后进行多变量协方差分析（MANCOVA）以评估研究组和对照组之间的差异。
与对照组相比，单侧SNHL受试者听力正常耳的耳蜗底转管腔宽度在大小上显著更大，外侧半规管骨岛的中心透明度在密度上显著更低。
单侧SNHL受试者的对侧听力正常耳存在内耳异常。这些数据表明，单侧SNHL患者可能有更广泛的疾病过程，导致双耳出现异常。耳蜗底转管腔宽度与“正常”相差> 5%和/或外侧半规管骨岛中心透明度与“正常”相差> 5%的发现可能表明小儿单侧感音神经性听力损失患者对侧未受影响耳存在内在风险。
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