听神经病谱系障碍患者与正常听力者的耳蜗神经及面神经影像学比较

Differences in Cochlear Nerve and Facial Nerve Dimensions between Auditory Neuropathy Spectrum Disorder Patients and Normal Hearing Adults

目的比较听神经病谱系障碍（ANSD）患者和正常听力者的内听道段耳蜗神经及面神经的直径和面积之间的差异。方法以2009年1月～2011年12月间华中科技大学附属同济医院耳鼻咽喉科确诊的11例ANSD的患者作为ANSD组，12例正常听力成人作为对照组，采用3DFIESTA序列的斜矢状位核磁共振成像技术分别测量两组对象内听道段耳蜗神经、面神经的直径和面积，比较两组间的差异。结果ANSD组耳蜗神经的最短直径（0．33±0．06mm）明显小于对照组（0．79±0．08mm），耳蜗神经的最长直径（0．52±0．07ram）小于对照组（1．00±0.08mm），耳蜗神经的横截面积（0．22±0．04mm2）也明显小于对照组（0．70±0．10mm2），差异均有统计学意义（均为P〈0．001）；而ANSD组的面神经最大直径、最小直径和面积与正常对照组接近，差异无统计学意义（P〉0．05）。结论ANSD患者的耳蜗神经明显较正常听力成人细小。

Objeclive To evaluate the dimensions of cochlear nerve and facial nerve in auditory neuropathy spectrum disorder （ANSD） patients and normal hearing adults on parasagitta[ magnetic resonance imaging （MRI）. Methods Medical records and MRI findings of 11 ANSD patients who visited Tongji hospital between January 2009 and December 2011 were reviewed ketrospectively. The diameters and cross--sectional areas of cochlear nerve （CN） and facial nerve （FN） at the fundus of the internal auditory canal （IAC） in two groups： ANSD group （22 ears） and normal hearing group （24 ears） were measured on the oblique plane sagittal view of MRI. Results The mean values and standard deviations of short and long diameters in ANSD patients were 0.33±0.06 mm and 0.52±0.07 mm re- spectively, they were significantly smaller than those in normal hearing subjects which were 0.79 ±0.08 mm and 1. 00±0.08 ram, respectively （P〈0. 001）. The mean and standard deviation of the cross--sectional area in ANSD pa- tients was 0.22±0.04 mm2. It was significantly smaller than that in normal hearing adults which was 0.70±0.10 mm2 （P〈0. 001）. The means values of diameters and area of the facial nerve were similar between ANSD patients and normal hearing adults and no statistically significant difference was found. Conclusion MRI can be used to accu- rately evaluate the dimensions of cochlear nerve and facial nerve in ANSD patients. The diameters and area of co- chlear nerve were significantly smaller than those in normal hearing subjects.