蜗神经管狭窄与蜗神经发育相关性研究

摘要

Objective To explore the relationship between cochlear nerve canal (CNC) stenosis and cochlear nerve (CN). Methods During a period of 16 months, 51 children (102 ears) with unilateral or bilateral sensorineural hearing loss (SNHL) underwent both HRCT and MRI imaging of temporal bone. First, the images of 51 children classification for inner ear malformations were analyzed; then 41 patients (82 ears) with normal inner acoustic canal (IAC) and cochlear existence were choosed from all patients, for these, the CNC were measured and divided into three groups according to the diameter of CNC on HRCT, a:>l. 8 mm, b: 1. 8~1. 5 mm, c: < 1. 5 mm, at the same time, the presence of CN hypo-plasia or aplasia were evaluated by MRI images; the relationship between CNC stenosis and CN were explored. Results 14 patients were found with inner ear malformation; in the 41 patients (82ears) with normal inner acoustic (IAC) and cochlear existence, 2 ears with CN hypoplasia and aplasia among 53 ears (CNC>0. 18 mm) were seen on MRI, among 15 ears with CNC diameter between 0. 18 mm and 0. 15 mm, of these, 2 ears had CN hypoplasia and aplasia, 12 ears of the remaining 14 ears (CNC<0. 15 mm) had hypogenetic cochlear nerves, It showed moderate correlation between the CNC and CN ( r =0. 641); The ratio of CN hypoplasia or aplasia were 3. 7% , 13. 3% , 85. 7% respectively. Conclusion Children with CNC stenosis had a high incidence of CN hypoplasia, width of CNC measurement <0. 15 mm highly supported the existence of CN hypoplasia. However, normal CN were seen in children with CNC stenosis, Therefore, It is indispensable to receive HRCT, MRI imaging before cochlear implantation (CI).%目的 探讨蜗神经管狭窄与蜗神经发育的相关性.方法 回顾性的分析51例(102耳)感音性耳聋(SNHL)患儿的颞骨HRCT及内耳MRI表现.对各种内耳畸形进行分类；从中选取41例(82耳)内听道正常并耳蜗存在的患儿,依据HRCT中蜗神经管(CNC)管径大小分三组,a:＞1.8mm,b:1.8～1.5mm,c:＜1.5mm,同时根据MRI表现将蜗神经(CN)分正常及发育不良,分析蜗神经管狭窄与蜗神经发育相关性.结果 51例患儿中14例出现不同程度内耳的畸形；41例82耳中53耳CNC＞0.18mm,其中2耳蜗神经发育不良；15耳CNC 1.8～1.5mm,2耳蜗神经发育不良；14耳CNC＜O.15mm,12耳蜗神经发育不良.所得数据进行Spearman相关性分析,相关系数r=0.641,各组蜗神经发育不良分别占3.7％、13.3％、85.7％.结论 蜗神经管狭窄与蜗神经发育呈中度正相关性,蜗神经管越窄,提示合并蜗神经发育不良准确性越高,CNC＜0.15mm,强烈提示蜗神经发育不良的存在,在HRCT诊断中要给予重视,但蜗神经管的狭窄可以有正常的蜗神经,因此人工耳蜗植入术前HRCT、MRI均是不可缺少的检查.