From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.).
Department of Radiology (A.F.), Jichi Medical University, Shimotsuke, Tochigi, Japan.
AJNR Am J Neuroradiol. 2019 Mar;40(3):551-557. doi: 10.3174/ajnr.A5985. Epub 2019 Feb 21.
Our aim was to identify whether specific patterns of ossification in labyrinthitis ossificans are associated with the known risk factors. Labyrinthitis ossificans has been described as sequela of prior temporal bone trauma, prior infection, and other disorders including sickle cell disease. Specific patterns of mineralization in the membranous labyrinth associated with these risk factors has not been previously described.
This was a retrospective study evaluating temporal bone CT scans at our institution from November 2005 to May 2018 in patients with labyrinthitis ossificans. Membranous labyrinthine structures evaluated for ossification included the following: basal, middle, and apical cochlear turns; lateral, posterior, and superior semicircular canals; and the vestibule for both ears in all patients. These structures were assigned a severity score, 0-4, based on degree of mineralization. Clinical records were reviewed for potential labyrinthitis ossificans risk factors. Basic descriptive statistics and a mixed model were used to correlate the degree and patterns of ossification with clinical history.
Forty-four patients (58 ears) with labyrinthitis ossificans were identified and evaluated. The most common risk factors were chronic otomastoiditis ( = 18), temporal bone surgery ( = 9), temporal bone trauma ( = 6), sickle cell disease ( = 5), and meningitis ( = 4). For all etiologies, the semicircular canals were most severely affected, and the vestibule was the least. In patients with prior temporal bone surgery, significantly greater mineralization was seen in the basal turn of the cochlea ( = .027), the vestibule ( = .001), and semicircular canals ( < .001-.008). No significant pattern was identified in patients with meningitis, sickle cell disease, or trauma.
Significant patterns of mineralization in labyrinthitis ossificans were observed in patients with prior temporal bone surgery. For all etiologies, the semicircular canals were most severely affected. No significant mineralization pattern was observed in patients with chronic otomastoiditis, meningitis, sickle cell disease, or prior temporal bone trauma.
本研究旨在明确在耳硬化症中，特定的骨化模式是否与已知的危险因素有关。耳硬化症被描述为颞骨外伤、感染和镰状细胞病等其他疾病的后遗症。与这些危险因素相关的膜迷路特定的矿化模式以前尚未描述过。
这是一项回顾性研究，评估了 2005 年 11 月至 2018 年 5 月在我院接受耳硬化症治疗的患者的颞骨 CT 扫描。评估的膜迷路结构包括：基底、中间和顶部耳蜗转；外侧、后侧和上半规管；以及双耳的前庭。根据矿化程度，这些结构被赋予 0-4 分的严重程度评分。回顾临床记录，寻找可能的耳硬化症危险因素。采用基本描述性统计和混合模型，将骨化程度和模式与临床病史相关联。
共确定并评估了 44 例（58 耳）耳硬化症患者。最常见的危险因素是慢性乳突炎（18 例）、颞骨手术（9 例）、颞骨外伤（6 例）、镰状细胞病（5 例）和脑膜炎（4 例）。对于所有病因，半规管的受累最严重，而前庭受累最轻。在有颞骨手术史的患者中，耳蜗底转（ =.027）、前庭（ =.001）和半规管（ <.001-.008）的矿化程度明显更高。在脑膜炎、镰状细胞病或外伤患者中，未发现明显的模式。
在有颞骨手术史的患者中，观察到耳硬化症的矿化模式存在显著差异。对于所有病因，半规管的受累最严重。在慢性乳突炎、脑膜炎、镰状细胞病或颞骨外伤患者中，未观察到明显的矿化模式。
