听力学及言语疾病杂志2024,Vol.32Issue(3) :221-227.DOI:10.3969/j.issn.1006-7299.2024.03.006

仅有部分底回的耳蜗发育不全畸形

Cochlear Hypoplasia with Partial Cochlear Basal Turn

赵堃 王乐 郝少娟 魏楠楠 叶放蕾
听力学及言语疾病杂志2024,Vol.32Issue(3) :221-227.DOI:10.3969/j.issn.1006-7299.2024.03.006

仅有部分底回的耳蜗发育不全畸形

Cochlear Hypoplasia with Partial Cochlear Basal Turn

赵堃 1王乐 1郝少娟 1魏楠楠 2叶放蕾1
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作者信息

  • 1. 郑州大学第一附属医院耳鼻咽喉头颈外科(郑州 450052)
  • 2. 郑州大学第一附属医院放射科
  • 折叠

摘要

目的 根据影像学特征探讨一种有别于目前Sennaroglu分类标准的特殊耳蜗畸形种类及其临床表现.方法 分析11例(13耳)特殊耳蜗畸形患者的颞骨高分辨率CT(HRCT)、3D-核磁(3D-MRI)表现和听力学结果,归纳此类耳蜗畸形的特点.结果 此类耳蜗畸形的影像学表现为仅有部分耳蜗底回自前庭腹侧发出,无转弯或仅有部分内侧转弯,无上底回、中回及顶回(耳蜗不足0.5圈),无蜗轴及阶间隔;在HRCT轴位图像上均未见到耳蜗与内听道(IAC)产生连接.MRI均显示蜗神经发育不良(CND),听力学均表现为全聋;大多伴有发育异常的前庭(12/13)和畸形的半规管(12/13),对侧耳蜗也多伴有严重畸形(10/13).根据影像学特点,此类耳蜗畸形仅有部分底回发育,属于耳蜗发育不全(CH),本研究将其命名为耳蜗发育不全X型(CH-X).结论 仅有部分底回(不足0.5圈)的耳蜗发育不全(CH-X)是一类严重的内耳畸形,约占内耳畸形的2%左右,患耳表现为全聋,由于畸形的耳蜗无明显的蜗孔和蜗神经,人工耳蜗植入可能获益较小.

Abstract

Objective To study a distinct type of cochlear malformation,differentiated by its radiological feature,from the current Sennaroglu's classification criteria along with its clinical manifestations.Methods By analyzing the radio-logical findings from high-resolution CT(HRCT)of the temporal bone and 3D-dimensional magnetic resonance imaging(3D-MRI)of the inner ear in 11 cases(13 ears)with special cochlear malformations,we summarized the characteristics of this type of cochlear deformity.Results ① The radiological features of this type of cochlear malformation showed that only a part of the cochlear basal turn originated ventrally from the vestibule,with no or only partial inward turning.There were no upper,middle,or apical turns(cochlea with less than 0.5 turns),and the modiolus and interscalar septa were absent.On HRCT axial images,there was no connection observed between the cochlea and the internal auditory canal(IAC).MRI results consistently showed a cochlear nerve deficiency(CND),with audiometric findings indicating complete hearing loss.Most cases were accompanied by abnormally developed vestibules and malformed semicircular canals,and the cochlea on the opposite side often had severe malformations as well.② Based on the imaging characteristics,this type of cochlear malfor-mation,with only partial development of the basal turn(cochlea with less than 0.5 turns),was categorized as cochlear hy-poplasia(CH).We provisionally designated it as cochlear hypoplasia type X(CH-X).Conclusion Cochlear hypoplasia(CH-X),characterized by cochlea with less than 0.5 turns,represents a severe type of inner ear malformation,accounting for approximately 2%of such deformities.Due to the malformed cochlea lacking a distinct bony cochlear nerve canal(BC-NC)and cochlear nerve(CN),the potential benefits of cochlear implant surgery may be relatively limited.

关键词

耳蜗畸形/耳蜗发育不全畸形/共同腔畸形/耳蜗发育不全Ⅰ型

Key words

Cochlear malformation/Cochlear hypoplasia/Common cavity/CH-1

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基金项目

中原英才计划(ZYYCYU202012117)

出版年

2024
听力学及言语疾病杂志
武汉大学人民医院

听力学及言语疾病杂志

CSTPCDCSCD北大核心
影响因子:1.16
ISSN:1006-7299
参考文献量23
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