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化脓性脑膜炎后耳蜗骨化所致耳聋的人工耳蜗植入:诊断与手术策略。

Cochlear implantation for post-meningitis deafness with cochlear ossification: diagnosis and surgical strategy.

机构信息

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.

出版信息

Acta Otolaryngol. 2022 May;142(5):369-374. doi: 10.1080/00016489.2022.2077433. Epub 2022 Jun 2.

Abstract

BACKGROUND

Cochlear ossification (CO) after meningitis can cause profound sensorineural hearing loss (SNHL). Cochlear implantation (CI) is the ideal treatment strategy for CO.

AIMS

To explore the strategy for CI in patients with CO after meningitis.

MATERIALS AND METHODS

In this retrospective study, the medical records of patients diagnosed with profound SNHL due to CO after meningitis and who underwent CI in our department between September 2010 and September 2021 were collected and reviewed. Their imaging and surgical findings were analyzed.

RESULTS

The data of 26 patients with unilateral CI were reviewed. All patients underwent preoperative temporal high-resolution computed tomography (HRCT) and 22 patients magnetic resonance imaging (MRI). The sensitivity of HRCT was 61.5% (10/26), whereas that of MRI was 81.8% (18/22). Combined HRCT and MRI achieved a detection rate of 92.3% (24/26). Twenty-two and four patients underwent complete and partial electrode implantations, respectively.

CONCLUSIONS AND SIGNIFICANCE

Preoperative temporal bone HRCT and MRI are essential for determining whether a patient is suitable for CI and surgical planning. A false-negative diagnosis is possible when diagnosing CO, but combined HRCT and MRI can improve the positive rate of preoperative diagnosis of CO post meningitis. Early CI is recommended.

摘要

背景

脑膜炎后耳蜗骨化(CO)可导致严重的感音神经性听力损失(SNHL)。人工耳蜗植入(CI)是 CO 的理想治疗策略。

目的

探讨脑膜炎后 CO 患者 CI 的策略。

材料和方法

本回顾性研究收集并回顾了 2010 年 9 月至 2021 年 9 月在我科因 CO 导致严重 SNHL 并接受 CI 的患者的病历。分析了他们的影像学和手术发现。

结果

回顾了 26 例单侧 CI 患者的数据。所有患者均行术前颞骨高分辨率计算机断层扫描(HRCT)和 22 例磁共振成像(MRI)。HRCT 的敏感度为 61.5%(10/26),MRI 的敏感度为 81.8%(18/22)。HRCT 和 MRI 联合检测率为 92.3%(24/26)。22 例和 4 例患者分别进行了完全和部分电极植入。

结论和意义

术前颞骨 HRCT 和 MRI 对于确定患者是否适合 CI 和手术计划至关重要。CO 的诊断可能出现假阴性,但 HRCT 和 MRI 联合可提高脑膜炎后 CO 术前诊断的阳性率。建议早期进行 CI。

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