Division of Otology & Neurotology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
Division of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.
Otol Neurotol. 2018 Dec;39(10):1319-1325. doi: 10.1097/MAO.0000000000002015.
To determine the prevalence of radiographic cochlear-facial nerve dehiscence (CFD).
Retrospective radiological study.
Two tertiary-referral centers.
Two hundred six temporal-bone computed tomography (CT) scans (405 total ears) of otology/neurotology patients from two academic institutions between the years 2014 and 2017.
Diagnostic.
The cochlear-facial nerve partition width (CFPW) was measured on coronal CT sections and defined as the shortest distance between the cochlear basal turn and facial nerve (FN) labyrinthine segment. We used logistics regression analyses to determine positive predictors for radiographic evidence of CFD.
The overall prevalence of radiographic CFD was 5.4% (22/406 ears). 9.2% of patients (19/206) had CFD. Of these 19 patients, only one patient had mixed hearing loss that could not be explained by any other vestibular or auditory etiology. Three out of 206 patients had dehiscence in both ears (1.4%). The average CFPW was 0.6 ± 0.2 mm, and fallopian canal width was 1.1 ± 0.02 mm (n = 405). Older age, use of traditional CT scans, and thinner CT slice thickness were significant predictors for radiographic CFD.
The radiographic prevalence of CFD is higher than what is reported in histologic studies, and may over-estimate the true prevalence of CFD. The clinician should keep this in mind when considering this as potential cause for third-window symptoms.
确定影像学耳蜗面神经裂（CFD）的患病率。
回顾性影像学研究。
两个三级转诊中心。
来自两个学术机构的 2014 年至 2017 年间的 206 例耳科学/神经耳科学患者的 206 个颞骨计算机断层扫描（CT）（405 只耳朵）。
诊断。
在冠状 CT 切片上测量耳蜗面神经分隔宽度（CFPW），定义为耳蜗基底转与面神经（FN）迷路段之间的最短距离。我们使用逻辑回归分析来确定影像学 CFD 证据的阳性预测因素。
影像学 CFD 的总体患病率为 5.4%（22/406 只耳朵）。9.2%的患者（19/206）有 CFD。在这 19 名患者中，只有 1 名患者有混合性听力损失，无法用任何其他前庭或听觉病因解释。206 名患者中有 3 名双耳裂（1.4%）。平均 CFPW 为 0.6±0.2mm，骨迷路宽度为 1.1±0.02mm（n=405）。年龄较大、使用传统 CT 扫描和较薄的 CT 切片厚度是影像学 CFD 的显著预测因素。
CFD 的影像学患病率高于组织学研究报告的患病率，可能高估了 CFD 的真实患病率。当考虑将其作为第三窗口症状的潜在原因时，临床医生应牢记这一点。
