磁共振成像在人工耳蜗植入术前评估中的价值

The clinical value of MRI in preoperative evaluation of cochlear implantation

目的探讨不同耳蜗植入者年龄、内耳畸形与人工耳蜗植入(CI)预后的关系,为聋儿提供术前评价及术后疗效预估的有效方法。方法选择2011年9月至2012年11月收治的有详细病史资料的84例先天性耳聋患儿,行头颅内听道MRI检查,患者的影像学检查结果、耳蜗植入年龄及CI术后听觉行为分级标准(CAP)及言语可懂度分级标准(SIR)评分进行列表,统计不同内耳畸形聋儿术后听力及言语恢复水平。结果不同耳蜗植入年龄对聋儿CI术后早期听觉及言语恢复有一定影响;内耳畸形组与无明显内耳畸形组CI术后CAP及SIR评分差异有统计学意义(P<0.05),但前庭导水管扩大聋儿与无明显内耳畸形聋儿预后无明显差异。结论磁共振成像对明确聋儿内耳有无畸形、畸形类型具有重要意义,内耳发育有无畸形与CI预后具有相关性。

Objective To explore the relation of cochlear implants age,inner ear malformation with prognosis after cochlear implan-tation (CI),and provide effective method for preoperative assessment and postoperative follow up.Methods Eighty-four children with con-genital deafness and detailed clinical data from September 201 1 to November 201 2 were recruited in this study.All children received MR ima-ging of inner ear and imaging finding,the age of cochlear implants were correlated with postoperative categories of auditory performance (CAP)and speech intelligengibity rating (SIR)score.The hearing and speech recovery level of different inner ear malformation was com-pared.Results The age of cochlear implants had some effects on early postoperative hearing and speech recovery.The postoperative CAP and SIR scores in children with inner ear malformation were different from those without obvious inner ear malformation,and the difference had sta-tistical significance,but the difference was not significant in children with large vestibular aqueduct.Conclusion MR imaging is a useful tool to clear the inner ear development situation,and the inner ear malformation has great relation with hearing and language outcome of CI.