Han Jae Joon, Bae Yun Jung, Song Seul Ki, Song Jae-Jin, Koo Ja-Won, Lee Jun Ho, Oh Seung Ha, Kim Bong Jik, Choi Byung Yoon
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul 04401, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
J Clin Med. 2019 Jan 24;8(2):136. doi: 10.3390/jcm8020136.
The goal of this study was to elucidate radiologic biomarker that can predict the outcome of cochlear implantation (CI) in congenital cytomegalovirus (cCMV) related deafness. A retrospective survey of speech perception after CI and an evaluation of brain magnetic resonance imaging (MRI) findings were performed in 10 cochlear implantees with cCMV-related prelingual deafness. Specifically, a special attention was paid to the degree of white matter (WM) abnormality shown in brain MRI, which was used to divide our cohort into two groups: The mild and severe pathology groups. Age-matched prelingual deaf patients with idiopathic sensorineural hearing loss were selected as controls. Subjects in mild pathology groups showed higher a Category of Auditory Performance (CAP) score (5.2 ± 0.8) than those with severe pathologies (3.4 ± 1.5) ( = 0.041). Importantly, speech performance from subjects with mild pathology was comparable to that of the control group (mean CAP score of 5.2 ± 0.8 vs. 5.1 ± 1.2) ( = 0.898). Mild pathologies related to the limited WM lesion in MRI not accompanied by severe MRI pathologies, such as diffuse WM abnormality, myelination delay, ventriculomegaly, migration abnormality, and cerebellar hypoplasia, can be tolerated and do not adversely affect the CI outcome in cCMV deafness.
本研究的目的是阐明可预测先天性巨细胞病毒(cCMV)相关性耳聋患者人工耳蜗植入(CI)效果的放射学生物标志物。对10例cCMV相关性语前聋的人工耳蜗植入者进行了CI术后言语感知的回顾性调查及脑磁共振成像(MRI)结果评估。具体而言,特别关注脑MRI显示的白质(WM)异常程度,据此将我们的队列分为两组:轻度和重度病变组。选择年龄匹配的特发性感音神经性听力损失语前聋患者作为对照。轻度病变组受试者的听觉表现类别(CAP)评分(5.2±0.8)高于重度病变组(3.4±1.5)(P = 0.041)。重要的是,轻度病变组受试者的言语表现与对照组相当(平均CAP评分5.2±0.8对5.1±1.2)(P = 0.898)。MRI中与有限WM病变相关的轻度病变,若不伴有严重的MRI病变,如弥漫性WM异常、髓鞘形成延迟、脑室扩大、迁移异常和小脑发育不全,则可耐受,且不会对cCMV耳聋患者的CI效果产生不利影响。