CT在内耳畸形儿童术前诊治中的应用

The Application of CT in the Diagnosis and Treatment of Children with Inner Ear Malformationbefore Surgery

目的探讨CT在内耳畸形儿童术前诊治中的应用价值。方法以2015年1月-2016年12月我院听力诊断中心诊治的120例内耳畸形患儿为对象,均行多层螺旋CT扫描检查,以3名内耳结构正常的儿童为对照,统计120例内耳畸形患儿CT检出和分类情况,并分析CT在内耳畸形儿童术前诊治中的应用价值。结果 120例患儿经CT扫描检查,共检出内耳畸形235耳,耳蜗畸形[包含耳蜗未发育(耳蜗结构缺失)、耳蜗发育不良(耳蜗较小,耳蜗螺旋≤1周)]、前庭畸形(前庭扩大亦或与耳蜗融合组成共同腔)、半规管畸形(半规管细小、扩大或缺裂)、内听道畸形(内听道狭窄或扩大)、前庭导水管畸形(前庭导水管开口呈喇叭状扩大且中段直径>1.5cm)各56、59、62、22、96例;单一结构畸形共20耳(8.51%),≥2种畸形共216耳(占比91.91%);120例内耳畸形患儿中双耳畸形115例(共230耳),占比95.83%,6例患儿双侧内耳畸形分类不一致,单耳畸形5例(共5耳),占比4.17%。结论 CT在内耳畸形儿童术前诊治中,可清晰显示内耳畸形分类和畸形程度情况,对提高内耳畸形准确诊断率及手术方案选择有重要参考价值。

Objective To investigate the value of CT in the diagnosis and treatment of children with inner ear malformation before surgery. Methods 120 children with inner ear malformation who were admittedto the Hearing DiagnosisCenter of the hospitalfrom January 2015 to December 2016 were selected as subjects, and they were examined by multislice spiral CT scan. Three children with normal inner ear structure were taken as controls. CT detection and classification of 120 children with inner ear malformation were statistically analyzed, and the value of CT in the diagnosis and treatment of children with inner ear malformation was analyzed. Results Of the 120 children examined by CT scan, there were 235 ears with inner ear malformations, and the numbers of cases with cochlear malformations [including cochlear aplasia（cochlear structure deletion）, cochlear dysplasia（relatively smaller cochlea, cochlear spiral≤1 cycle）], vestibular malformations（vestibular enlargement or fusion with cochlea forming common cavity）, semicircular canal malformations（small, expand or cracked semicircular canal）, internal auditory canal malformations（internal auditory canal stenosis or enlargement）, vestibular aqueduct malformations（vestibular aqueduct opening being trumpet shaped enlargementand middle diameter 〉1.5 cm） were 56, 59, 62, 22 and 96, respectively. There were a total of 20 ears（8.51%） with single structural malformations and 216 ears（91.91%） with more than 2 kinds of malformations. There were 115 cases（230 ears） with bilateral ears malformations in the 120 children with inner ear malformations, accounting for 95.83%. 6 children had different types of inner ear malformations. There were 5 cases（5 ears） with monaural malformation, accounting for 4.17%. Conclusion CT can clearly show the classification of inner ear malformation and the degree of malformation in the preoperative diagnosis and treatment of children with inner ear malformations, which is of important reference value for improving the accurate diagnosis rate of inner ear malformation and the selection of surgical plan.