锥形束计算机断层扫描对鼓膜完整的传导性或混合性听力损失的诊断价值。
Diagnostic Value of Cone-Beam Computed Tomography in Conductive or Mixed Hearing Loss with Intact Tympanic Membrane.
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
出版信息
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241272384. doi: 10.1177/19160216241272384.
BACKGROUND
Conductive or mixed hearing loss with an intact tympanic membrane is a group of diseases characterized by similar clinical symptoms. Definitive diagnosis depends on the findings of exploratory tympanic surgery. Cone-beam computed tomography (CBCT) has great potential for middle ear imaging. This study evaluated the diagnostic value of CBCT for conductive or mixed hearing loss with an intact tympanic membrane.
METHODS
CBCT and high-resolution computed tomography (HRCT) imaging data were collected from patients with an intact eardrum who received medical treatment in our hospital for conductive or mixed hearing loss from October 2020 to May 2023. The imaging characteristics and diagnostic values of CBCT and HRCT were analyzed.
RESULTS
A total of 137 patients who met the inclusion criteria and underwent CBCT were enrolled, including 89 with otosclerosis, 41 with ossicular chain interruption, and 7 with tympanosclerosis. CBCT clearly displayed a middle ear focus, such as low-density lesions located in the fissula ante fenestram, ossicular chain malformation or dislocation, and tympanic calcification foci. The area under the curve values for otosclerosis, ossicular chain interruption, and tympanic sclerosis were 0.934, 0.967, and 0.850, respectively. CBCT was more effective than HRCT for visualizing the lenticular process, incudostapedial joint, and stapes footplate.
CONCLUSIONS
CBCT of the middle ear demonstrated higher-quality imaging to improve the diagnosis of conductive or mixed hearing loss with an intact tympanic membrane. Therefore, CBCT is recommended for further investigation of noninflammatory diseases of the middle ear with no special findings on HRCT.
背景
鼓膜完整的传导性或混合性听力损失是一组具有相似临床症状的疾病。明确诊断依赖于鼓室探查手术的结果。锥形束 CT（CBCT）在中耳成像方面具有巨大潜力。本研究评估了 CBCT 对鼓膜完整的传导性或混合性听力损失的诊断价值。
方法
收集 2020 年 10 月至 2023 年 5 月期间因传导性或混合性听力损失在我院接受治疗的鼓膜完整患者的 CBCT 和高分辨率 CT（HRCT）影像学数据。分析 CBCT 和 HRCT 的影像学特征和诊断价值。
结果
共纳入符合纳入标准并接受 CBCT 检查的 137 例患者，其中耳硬化症 89 例，听骨链中断 41 例，鼓膜硬化症 7 例。CBCT 清晰显示中耳焦点，如位于前窗下裂隙的低密度病变、听骨链畸形或脱位以及鼓膜钙化灶。耳硬化症、听骨链中断和鼓膜硬化症的曲线下面积值分别为 0.934、0.967 和 0.850。CBCT 比 HRCT 更能有效地观察镫骨足板、砧镫关节和镫骨。
结论
中耳 CBCT 显示出更高质量的成像，有助于提高鼓膜完整的传导性或混合性听力损失的诊断。因此，对于 HRCT 无特殊发现的中耳非炎症性疾病，建议进一步进行 CBCT 检查。
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