Wu S H, Ma X L
Department of Otorhinolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Oct 7;54(10):734-740. doi: 10.3760/cma.j.issn.1673-0860.2019.10.006.
The radiological and audiological results of patients with hearing loss associated with enlarged vestibular aqueduct (EVA) were analyzed statistically to explore the association between them. In this retrospective study, we screened 64 patients (128 ears) with EVA diagnosed in the Department of Otorhinolaryngology, Shengjing Hospital of China Medical University from January 2012 to June 2016, who met the inclusion criteria and the exclusion criteria at the same time, including 37 males (74 ears) and 27 females (54 ears), aged from 6 months to 17 years, all of whom showed varying degrees of sensorineural hearing loss (SNHL). The imaging observations included the midpoint measurement (MP) and the operculum measurement(OP) of the temporal bone HRCT, the long signal area cross-sectional area (ES(L)), the short signal area cross-sectional area (ES(S)), as well as the largest total signal area cross-sectional area (ES(T)) of the endolymphatic sac(ES) of the cochlear MRI. The audiological observations included collecting detailed medical history and subjective and/or objective audiological examinations to determine the character and degree of hearing loss. According to the progress and changes of hearing loss, they were divided into hearing stability group (86 ears) and fluctuation/progression group (42 ears). SPSS22.0 statistical software was used to carry out statistical analysis of the imaging measurement results. The sizes of MP and OP were smaller in the stable group than those in the fluctuating/progressive group, and the difference was statistically significant (<0.05). For ES(L), ES(S) or ES(T), there was no significant difference between the stable group and the fluctuating/progressive group (>0.05). For the 13 patients with asymmetric hearing loss, the sizes of MP, OP, ES(L), ES(S) or ES(T) were not significantly different between the mild side and the serious side (>0.05). For the ears whose ES(L)/ES(S) was>2 or the ES(S)/ES(L) was>2, the proportion was not significantly different between the stable group and the fluctuating/progressive group (>0.05). For patients with EVA,the smaller the enlarged vestibular aqueduct is,the more likely it is congenital severe sensorineural hearing loss. Patients with significantly enlarged vestibular aqueduct often exhibit volatility/progressive hearing loss. The degree of enlargement of the endolymphatic vessels and endolymphatic sac is not related to the degree of hearing loss. For EVA patients with asymmetric hearing loss, the mild or serious side of hearing loss is random, which is not affected by the degree of enlargement of the vestibular aqueduct and endolymphatic sac. The degree of hearing loss in patients with EVA is not related to the ratio of ES(L)/ES(S).
对大前庭导水管（EVA）相关听力损失患者的放射学和听力学结果进行统计分析，以探讨两者之间的关联。在这项回顾性研究中，我们筛选了2012年1月至2016年6月在中国医科大学附属盛京医院耳鼻咽喉科诊断为EVA的64例患者（128耳），这些患者同时符合纳入标准和排除标准，其中男性37例（74耳），女性27例（54耳），年龄6个月至17岁，均表现出不同程度的感音神经性听力损失（SNHL）。影像学观察包括颞骨HRCT的中点测量（MP）和骨盖测量（OP）、耳蜗MRI内淋巴囊（ES）的长信号区横截面积（ES(L)）、短信号区横截面积（ES(S)）以及最大总信号区横截面积（ES(T)）。听力学观察包括收集详细病史以及主观和/或客观听力学检查，以确定听力损失的性质和程度。根据听力损失的进展和变化，将其分为听力稳定组（86耳）和波动/进展组（42耳）。使用SPSS22.0统计软件对影像学测量结果进行统计分析。稳定组的MP和OP尺寸小于波动/进展组，差异有统计学意义（<0.05）。对于ES(L)、ES(S)或ES(T)，稳定组与波动/进展组之间无显著差异（>0.05）。对于13例不对称听力损失患者，轻度侧和重度侧的MP、OP、ES(L)、ES(S)或ES(T)尺寸无显著差异（>0.05）。对于ES(L)/ES(S)>2或ES(S)/ES(L)>2的耳，稳定组与波动/进展组之间的比例无显著差异（>0.05）。对于EVA患者，前庭导水管扩大越小，越可能是先天性重度感音神经性听力损失。前庭导水管明显扩大的患者常表现出波动性/进行性听力损失。内淋巴管和内淋巴囊的扩大程度与听力损失程度无关。对于不对称听力损失的EVA患者，听力损失的轻度或重度侧是随机的，不受前庭导水管和内淋巴囊扩大程度的影响。EVA患者的听力损失程度与ES(L)/ES(S)比值无关。
