Bu H, Chen P, Wu Z G, Xu Y L, Zou B, Su Y P
Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Aug 7;54(8):561-565. doi: 10.3760/cma.j.issn.1673-0860.2019.08.001.
To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (±, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant ( value was 2.814 and 2.754, 0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant( value was 0.101 and 0.683, 0.05). There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.
探讨大前庭导水管综合征（LVAS）患者的影像学特征及其与听性诱发短潜伏期负反应（ANSR）的关系，为LVAS的诊断提供参考。回顾性分析2009年10月至2017年12月广西医科大学第一附属医院耳鼻咽喉头颈外科收治的174例（334耳）LVAS患者的临床资料，其中男117例，女57例，年龄5个月至47岁，中位年龄4岁4个月。收集患者的听性脑干反应（ABR）及影像学资料。在CT图像上测量前庭导水管中点直径及出口直径，在MRI图像上测量扩大内淋巴囊（EES）骨内段及骨外段中点直径。采用SPSS 17.0软件进行检验分析上述测量值之间的相关性。根据ABR检查是否引出ASNR，将上述数据分为两组，采用独立样本检验比较两组上述影像学测量值的差异。LVAS患者前庭导水管平均中点直径为（1.87±0.58）mm（±，下同），CT上出口直径为（3.07±0.99）mm；EES骨内段平均中点直径在MRI上为（2.39±1.37）mm，骨外段为（2.50±2.18）mm。四项测量值之间存在相关性（P＜0.05），其中前庭导水管中点直径与出口直径呈强正相关（r=0.760），其余各对呈弱相关。334耳LVAS患者中，241耳（72.16%，241/334）引出ASNR，93耳（27.84%，93/334）未引出ASNR。未引出ASNR组的前庭导水管中点直径及出口直径均小于引出ASNR组，差异有统计学意义（t值分别为2.814、2.754，P＜0.05）。两组EES骨内段及骨外段中点直径差异无统计学意义（t值分别为0.101、0.683，P＞0.05）。LVAS患者前庭导水管中点直径与出口直径呈强正相关。前庭导水管大小与内淋巴囊大小存在一定相关性。前庭导水管直径越小，ASNR发生率越低。
