颞骨轴位高分辨CT在人工耳蜗植入中的指导作用及术后评估价值研究  

Guiding Role and Postoperative Evaluation Value of Temporal Bone Axial High Resolution CT in Cochlear Implantation

作　　者：刘永刚[1] 魏璐璐[1] LIU Yong-gang;WEI Lu-lu(Department of Otolaryngology,the Affiliated Hospital of Zhengzhou University Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]郑州大学附属医院南阳市中心医院耳鼻喉科,河南南阳473000

出　　处：《中国CT和MRI杂志》2022年第10期20-21,24,共3页Chinese Journal of CT and MRI

摘　　要：目的探究颞骨轴位高分辨CT(HRCT)在人工耳蜗植入(CI)中的指导作用及术后评估价值。方法研究选取2018年5月至2020年5月86例(108患耳)行CI治疗的感音神经性耳聋(SNHL)患者,所有患者术前、术后均有HRCT检查,分析HRCT检查图像质量、术前内耳发育畸形检出情况、内耳解剖结构检查效果及术后电极植入情况。结果患者术前、术后HRCT图像质量均可满足诊断需求,优良率分别达97.67%、96.51%;术前检出52例患者(68耳)存在内耳畸形,其中前庭导水管扩大28耳,耳蜗畸形16耳,半规管发育畸形11耳,耳蜗神经发育不良8例,内听耳道畸形5例;HRCT术前所测面神经到前庭窗、蜗窗距离及面神经隐窝到前庭窗、蜗窗水平截面距离与术中实测结果比较差异均无统计学意义(P>0.05);CI术后HRCT检查显示,共12例(11.11%)电极植入异常,其中不伴内耳畸形植入异常发生率2.50%,明显低于伴内耳畸形的16.18%(P<0.05)。结论HRCT用于CI患者术前、术后检查,图像质量好,可客观显示患者内耳发育情况及解剖结构,有利于指导手术顺利进行,评价电极植入效果,值得临床应用。Objective To explore the guiding role and postoperative evaluation value of temporal bone axial high-resolution CT(HRCT)in cochlear implantation(CI).Methods From May 2018 to May 2020,86 cases(108 ears)of patients with sensorineural hearing loss(SNHL)undergoing CI were selected.All patients had HRCT examination before and after surgery,and the image quality of HRCT examination,detection of preoperative inner ear developmental malformations,examination effect of inner ear anatomical structure and postoperative electrode implantation were analyzed.Results The HRCT image quality of the patients before and after surgery could meet the diagnostic needs,and the excellent and good rates were up to 97.67%and 96.51%respectively.52 patients(68 ears)were found to have inner ear malformations before surgery,including 28 ears with enlarged vestibular aqueducts,16 ears with cochlear malformations,11 ears with semicircular canal developmental malformations,8 eyes with cochlear nerve dysplasia and 5 eyes with internal auditory auditory canal malformations.There were statistically significant differences in the distance from facial nerve to vestibular window,the distance from facial nerve to cochlear window and the horizontal cross section distances from facial nerve recess to vestibular window and to cochlear window measured before HRCT compared with those of intraoperative measured results(P>0.05).HRCT examination after CI showed that a total of 12 cases(11.11%)had abnormal electrode implantation,and the incidence rate of abnormal implantation without inner ear malformations was significantly lower than that of with inner ear malformations(2.50%vs 16.18%)(P<0.05).Conclusion HRCT for preoperative and postoperative examination of CI patients can have good image quality,and can objectively show the inner ear development and anatomical structure.It is helpful to guide the smooth operation and evaluate the electrode implantation effect.Thus it is worthy of clinical application.

关 键 词：感音神经性耳聋 人工耳蜗植入 高分辨率CT 术前指导 术后评估 

分 类 号：R445.3[医药卫生—影像医学与核医学]