【摘要】： 目的 探討嬰幼兒感音性神經性耳聾的臨床特點,評估高分辨CT (HRCT)對感音性神經性耳聾的診斷價值和指導治療的意義。 方法 對20例經腦干聽覺誘發(fā)電位(ABR)確診的中重度感音神經性耳聾(SNHL)患者行HRCT螺旋掃描,原始數(shù)據(jù)采集完后,按層厚0.625mm,重建間隔0.3mm,單側FOV9.6cm放大重建,再傳至工作站行多平面重建(MPR)并利用最小密度投影(Min IP)、容積漫游(VR)及其疊加技術等后處理方法觀察內耳結構。 結果 20例感音神經性耳聾患者中有37耳先天性內耳畸形,其中耳蝸未發(fā)育1耳、共同腔畸形1耳、不完全分隔Ⅰ型1耳、不完全分隔Ⅱ型即Mondini畸形8耳、前庭和半規(guī)管畸形22耳、前庭導水管擴大20耳、內耳道畸形8耳,伴內耳道底發(fā)育不全3耳、外耳道骨性閉鎖2耳、面神經管異常4耳、前庭窗閉鎖2耳、蝸窗閉鎖1耳。 結論 嬰幼兒感音性神經性耳聾主要病因為先天性內耳發(fā)育異常,臨床表現(xiàn)不典型,易忽視病情,HRCT螺旋掃描結合后處理技術能清楚顯示內耳的結構,為先天性內耳畸形的部位和程度明確其分類,為進一步指導治療及預后提供有力的依據(jù)。
[Abstract]:Objective to investigate the clinical features of sensorineural hearing loss in infants and to evaluate the value of high resolution CT (HRCT) in diagnosis and treatment of sensorineural hearing loss. Methods HRCT spiral scanning was performed in 20 patients with moderate and severe sensorineural hearing loss (SNHL) diagnosed by brainstem auditory evoked potential (ABR). After the original data were collected, the slice thickness was 0.625 mm, the reconstruction interval was 0.3 mm, and the unilateral FOV9.6 cm was amplified and reconstructed. Then it was transferred to the workstation for multiplanar reconstruction (MPR). The inner ear structure was observed by the methods of minimum density projection (Min IP), volume roaming (VR) and superposition technique. Results among the 20 cases of sensorineural deafness, 37 ears were congenital inner ear malformation, including 1 undeveloped cochlea, 1 common cavity malformation, 1 incomplete separation of type I and 8 mondini deformities. 22 ears of vestibular and semicircular canal malformation, 20 ears of vestibular aqueduct enlargement, 8 ears of inner auditory canal malformation, 3 ears of dysplasia of internal auditory meatus, 2 ears of osseous atresia of external auditory meatus, 4 ears of abnormal facial canal, 2 ears of atresia of vestibular window and 1 ear of atresia of cochlear window. Conclusion the main cause of sensorineural deafness in infants is congenital inner ear dysplasia, atypical clinical manifestation, and the structure of inner ear can be clearly displayed by HRCT spiral scan combined with post-processing technique. The classification of congenital inner ear malformation is clear for its location and degree, and it provides a powerful basis for the treatment and prognosis of congenital inner ear malformation.
【學位授予單位】：中國醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R764

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