D Deeksha D, Patil G C
Otolaryngology-Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubballi, IND.
Radiology, Karnataka Institute of Medical Sciences, Hubballi, IND.
Cureus. 2023 Jul 19;15(7):e42160. doi: 10.7759/cureus.42160. eCollection 2023 Jul.
Background Congenital sensorineural hearing loss (SNHL) is one of the most common birth defects with an incidence ratio of 1:1000 live births in India. Imaging plays an important role in the evaluation of congenital SNHL. As there is a paucity of studies in the Indian setting to determine the prevalence of inner-ear abnormalities, this study attempts to throw light on the various inner-ear anomalies that are prevalent in our setup in the Northern part of Karnataka using high-resolution computed tomography (HRCT) temporal bone scan. Objectives The objectives of this study are estimation of the prevalence of inner-ear anomalies in children with congenital SNHL by employing a radiologic assessment of HRCT temporal bone scans and determination of the factors associated with the identification of these abnormalities like demographic factors and degree of hearing loss. Methods Children with congenital SNHL underwent clinical evaluation with history taking and general and ear examination. Otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA) measurements were obtained. A radiological assessment by HRCT temporal bone scan was done. Using the classification criteria of inner-ear malformations by Jackler and Sennaroglu as a reference, diagnostic standards were established in studying inner-ear malformations. Data were collected and entered in a Performa, which includes patient's demography, audiological findings, and radiological findings, and the results were analyzed. Data were entered into Microsoft Excel, and statistical analysis was carried out using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States). Categorical variables were presented as frequency and percentage. Then the prevalence of inner-ear anomaly was estimated. Correlation between inner-ear anomaly and other factors was calculated using the Chi-square test. Results The prevalence of inner-ear anomalies identified in congenital SNHL by HRCT scan was as follows: 26.08% (12/46), 26.1% (24/92) of inner ears was anomalous, 23.9% of the cochlea was anomalous, 6.5% of the vestibule was anomalous, 5.4% of the vestibular aqueduct was anomalous, and 3.2% of the semicircular canal was anomalous. Cochlear aplasia, incomplete partition, common cavity, and cochlear hypoplasia were the anomalies found. Few cochleas had an abnormal cochlear height, though they appeared normal structurally. The dilated vestibule was the most common vestibular abnormality. There was a negative association found between the inner-ear anomaly in children with congenital SNHL who had a history of consanguineous marriage in their parents. Conclusion High-resolution temporal CT scanning could provide detailed information on the pathology of the inner ear in congenital SNHL, which can help in better planning the surgery for cochlear implantation and understanding the prognosis.
先天性感音神经性听力损失(SNHL)是最常见的出生缺陷之一,在印度活产婴儿中的发病率为1:1000。影像学在先天性SNHL的评估中起着重要作用。由于在印度环境中缺乏确定内耳异常患病率的研究,本研究试图通过高分辨率计算机断层扫描(HRCT)颞骨扫描,揭示卡纳塔克邦北部我们所在地区普遍存在的各种内耳异常情况。
本研究的目的是通过对HRCT颞骨扫描进行放射学评估,估计先天性SNHL儿童内耳异常的患病率,并确定与这些异常识别相关的因素,如人口统计学因素和听力损失程度。
对先天性SNHL儿童进行临床评估,包括病史采集、全身和耳部检查。进行耳声发射(OAE)和脑干诱发反应测听(BERA)测量。通过HRCT颞骨扫描进行放射学评估。以Jackler和Sennaroglu的内耳畸形分类标准为参考,建立研究内耳畸形的诊断标准。收集数据并录入一份表格,其中包括患者的人口统计学信息、听力学检查结果和放射学检查结果,并对结果进行分析。数据录入Microsoft Excel,使用IBM SPSS Statistics for Windows 27版(2020年发布;IBM公司,美国纽约州阿蒙克)进行统计分析。分类变量以频率和百分比表示。然后估计内耳异常的患病率。使用卡方检验计算内耳异常与其他因素之间的相关性。
通过HRCT扫描在先天性SNHL中发现的内耳异常患病率如下:26.08%(12/46),26.1%(24/92)的内耳异常,23.9%的耳蜗异常,6.5%的前庭异常,5.4%的前庭导水管异常,3.2%的半规管异常。发现的异常包括耳蜗发育不全、不完全分隔、共同腔和耳蜗发育不良。少数耳蜗虽然结构上看起来正常,但耳蜗高度异常。扩张的前庭是最常见的前庭异常。在父母有近亲结婚史的先天性SNHL儿童中,内耳异常之间存在负相关。
高分辨率颞骨CT扫描可以提供先天性SNHL内耳病理学的详细信息,这有助于更好地规划人工耳蜗植入手术并了解预后。