双侧前庭导水管扩大患者合并其他内耳畸形及双侧内耳径线值对比分析

Prevalence of Other Inner Ear Malformations and Bilateral Comparison of the Size of Inner Ear Structures in Patients with Bilateral Large Vestibular Aqueduct

目的应用高分辨率CT探究双侧前庭导水管扩大畸形(large vestibular aqueduct,LVA)患者合并其他内耳畸形的发生率,并对比分析双侧内耳径线值的差异。方法回顾性分析75例(平均年龄6.53±6.13岁,男性45例,女性30例)双侧LVA患者的高分辨率CT图像,评估各种内耳畸形的发生率,测量双侧内耳道径线、前庭左右径、前庭导水管中段的前后径、蜗神经孔宽度、耳蜗的高度、耳蜗底周外径、耳蜗底周蜗螺旋管管径、耳蜗底周上半周宽度、耳蜗中周下半周宽度、耳蜗中周高度,并进行对比分析。结果入组的75例双侧LVA患者中,55例(73.3%)合并双耳蜗轴缺如,42例(56.0%)合并双耳蜗顶中周融合,59例(78.7%)合并双侧前庭扩大,1例(1.3%)合并双侧内耳道狭窄,合并畸形的发生率在男女患者之间无显著差异(P>0.05)。在所有内耳径线测量值中,双侧内耳道横断面前后径有显著差异[4.71±0.80 mm(左侧)vs.4.57±0.78 mm(右侧);P=0.019],其他结构径线值双侧均无显著差异(P>0.05)。结论双侧LVA患者常合并多种内耳畸形,以双侧前庭扩大常见,双侧内耳道横断面径线值可能存在非对称性表现。

Objective To determine the prevalence of other inner ear malformations and compare the size of inner ear structures in patients with bilateral large vestibular aqueduct(LVA)using high resolution computed tomography(CT).Methods We retrospectively analyzed the high resolution CT images of 75 patients with bilateral LVA(mean age:6.53±6.13 years old;45 males).The prevalence of co-existing other inner malformations was determined.The size of inner ear structures including the diameters for internal auditory canal,vestibule,middle segment of vestibular aqueduct,cochlear foramen,and cochlear was measured and compared bilaterally.Results Of the 75 recruited patients with bilateral LVA,55(73.3%)had deficit of bilateral cochlear axis,42(56.0%)had bilateral periapical fusion of cochlea,59(78.7%)had bilateral large vestibule,and 1(1.3%)had bilateral stenosis in internal auditory canal,respectively.The prevalence of other inner malformations between male and female patients with bilateral LVA was not significantly different(all P>0.05).Among the size of inner ear structures,only the diameter of internal auditory canal at axial view was significant different between left and right side(4.71±0.80 mm[left]vs.4.57±0.78 mm[right];P=0.019).There were no significant differences in the size of other inner ear structures between left and right side(all P>0.05).Conclusion We found that the co-existing other inner ear malformations were prevalent in patients with bilateral LVA,particularly bilateral large vestibule.In patients with bilateral LVA,the diameter of bilateral internal auditory might be asymmetric.