CT与磁共振成像在儿童人工耳蜗植入术前研究

目的　评价CT与磁共振成像 (magneticresonanceimaging ,MRI)在儿童人工耳蜗植入术前的诊断作用 ,以及对手术选择的影响。方法　 71例 ( 142耳 )双耳重度耳聋、拟行人工耳蜗植入的患儿进行术前CT与MRI检查。结果　CT与MRI均发现 ,12例 ( 2 2耳 )患者有前庭水管扩大 ( 15 5 % ) ;14例 ( 2 5耳 )患儿有Mondini畸形 ( 17 6% ) ;3例 ( 5耳 )患儿有内耳道扩大 ( 3 5 % ) ;2例 ( 4耳 )患者有可疑内耳道底骨质缺损 ( 2 8% )。MRI发现有 5例 ( 5耳 )患者单侧耳蜗纤维化 ( 3 5 % ) ,而CT未见异常。1例 ( 2耳 )患儿的CT显示面神经裸露 ( 1 4% ) ,MRI正常。结论　人工耳蜗植入术前应该进行CT与MRI检查。对于发现前庭水管综合征、Mondini畸形、内耳道扩张及内耳道底骨质缺损有重要意义。这二种影像学检查结果可以相互补充诊断耳蜗纤维化与面神经裸露。对手术适应证的选择以及保证手术正常进行有重要意义

Radiological study of temporal bone in children with profound deafness before cochlear implant: CT vs magnetic resonance imaging

Objective To evaluate the clinical application of magnetic resonance imaging (MRI) and CT in children with profound deafness before cochlear implant and their impact on surgical decision. Methods The pre-operative CT and MRI data from 71 children with bilateral profound deafness planned for cochlear implant were studied. Results 12 patients showed enlarged vestibular aqueduct (16.9%); 14 patients had Mondini malformation (19.7%); 3 patients demonstrated enlarged internal auditory meatus (4.2%); and 2 patients were suspected to have fistulae (2.8%) on both CT and MRI examinations. In comparison between MRI and CT, unilateral cochlear fibrosis was detected in 5 patients(7%) by MRI, but none by CT scans. Bilateral dehiscent facial nerve was detected in 1 patient(1.4%) by CT scan, while MRI was normal. Conclusion CT and MRI are essential for the pre-operative planning of cochlear implant, especially in patients with enlarged vestibular aqueduct, Mondini malformation, enlarged internal auditory meatus and suspected fistulae. These two imaging modalities are complementary to each other in cases with cochlear fibrosis and facial nerve dehiscence.