人工耳蜗植入术前CT评估

CT evaluation of preoperative cochlear implantation cochlear implantation

目的探讨CT检查对人工耳蜗植入术前评估的价值。方法对93例感音性耳聋患者均采用颞骨轴位高分辨率CT螺旋扫描及内耳三维重建。结果81例先天性感音耳聋患者中检出7例13耳Mondini畸形,5例8耳大前庭水管综合症(largevestibularaqueductsyndrome,LVAS),1例2耳内耳骨化;1例2耳内耳纤维化患者CT扫描正常,而MRI能够显示其信号明显减低,术中证实由于纤维组织阻塞,电极不能植入耳蜗底周;另12例语后聋患者中检出2例4耳慢性化脓性中耳炎,1例2耳内耳骨化。结论人工耳蜗植入术前评估,CT检查必不可少。对手术适应证的选择以及保证手术顺利进行有重要意义。MRI水成像是必要的补充。

Objective To evaluate CT scan as a preoperative evalua tion for cochlear implantation candidates. Methods Axial high-resolution temporal bone CT and three-dimensional reco nstruction of inner ear were performed in 93 patients with sensorineural hearing loss. Results Among 81 patients with congenital sensorineural deafness, Mondin i malformation was seen in 7 case (13 ears ); large vestibular aqueduct syndrome (LVAS) was revealed in 5 cases ( 8 ears ) ; and inner ear ossification was found in 1 case ( 2 ears ). In 1 case ( 2 ears ) of inner ear fibrosis, reduced cochl ear signal was noted on MRI but no unremarkable findings was shown on CT scan, h owever, in the operation, the device could not inserted into the basal circle of the cochlea, due to fibrous obliteration. In 12 patients with post-speech dea fness, chronic suppurative tympanitis was seen in 2 cases (4 ears ), and inner e ar ossification was revealed in 1 case ( 2 ears ) . Conclusion CT plays an indi spensable role in the pre-operative evaluation of cochlear implantation. T2-weighted FSE-MRI of the inner ear is a useful complementary to CT scan.