Department of Pediatric Audiology, Stanford Medicine Children's Health, Palo Alto, California, USA.
Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
Otolaryngol Head Neck Surg. 2023 Aug;169(2):390-396. doi: 10.1002/ohn.255. Epub 2023 Feb 7.
This study aimed to assess the prevalence of cochlear nerve deficiency (CND) in a cohort of pediatric patients with single-sided deafness (SSD). A secondary objective was to investigate trends in intervention and hearing device use in these children.
Case series with chart review.
Pediatric tertiary care center.
Children ages 0 to 21 years with SSD (N = 190) who underwent computerized tomography (CT) and/or magnetic resonance imaging (MRI) were included. Diagnostic criteria for SSD included unilateral severe-to-profound sensorineural hearing loss with normal hearing sensitivity in the contralateral ear. Diagnostic criteria for CND included neuroradiologist report of an "aplastic or hypoplastic nerve" on MRI or a "stenotic cochlear aperture" on CT.
The prevalence of CND was 42% for children with CT only, 76% for children with MRI only, and 63% for children with both MRI and CT. Of the children with MRI and CT, there was a 90% concordance across imaging modalities. About 36% of children with SSD had hearing devices that routed sound to the normal hearing ear (ie, bone conduction hearing device/contralateral routing of signal), while only 3% received a cochlear implant. Approximately 40% did not have a hearing device. Hearing device wear time averaged 2.9 hours per day and did not differ based on cochlear nerve status.
There is a high prevalence of CND in children with SSD. Cochlear nerve status should be confirmed via MRI in children with SSD. The limited implementation and use of hearing devices observed for children with SSD reinforce the need for increased support for early and continuous intervention.
本研究旨在评估单侧听力损失(SSD)患儿中耳蜗神经缺失(CND)的发生率。次要目的是调查这些儿童干预和听力设备使用的趋势。
病例系列,图表回顾。
儿科三级保健中心。
纳入年龄在 0 至 21 岁之间、有 SSD(N=190)并接受计算机断层扫描(CT)和/或磁共振成像(MRI)的儿童。SSD 的诊断标准包括单侧严重至极重度感音神经性听力损失,对侧耳听力正常。CND 的诊断标准包括神经放射学家在 MRI 上报告“发育不良或发育不全的神经”或 CT 上报告“耳蜗孔狭窄”。
仅 CT 检查的儿童 CND 发生率为 42%,仅 MRI 检查的儿童 CND 发生率为 76%,同时进行 MRI 和 CT 检查的儿童 CND 发生率为 63%。在同时进行 MRI 和 CT 的儿童中,两种成像方式的一致性为 90%。约 36%的 SSD 儿童使用将声音传至正常听力耳的听力设备(即骨导听力设备/对侧信号转导),而只有 3%的儿童接受了人工耳蜗植入。约 40%的儿童没有使用听力设备。听力设备佩戴时间平均每天 2.9 小时,与耳蜗神经状态无关。
SSD 儿童 CND 的发生率较高。SSD 儿童应通过 MRI 确认耳蜗神经状态。观察到 SSD 儿童听力设备的实施和使用有限,这强调了需要增加对早期和持续干预的支持。