锥形束CT评估内耳畸形患者人工耳蜗植入术后电极形态的研究
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摘要
目的探讨锥形束CT评估内耳畸形患者人工耳蜗植入术后电极形态的方法及价值。方法选取19例(年龄1～29岁,中位年龄6岁,14岁以下者14例)伴内耳畸形的重度-极重度感音神经性聋患者,其中,大前庭水管10例,Mondini畸形6例,共同腔畸形2例,Charge综合症伴耳蜗发育不全1例;19例患者中同期双侧植入人工耳蜗2例,左侧植入4例,右侧植入13例。所有患者均于术后1～2天进行植入侧颞骨锥形束CT扫描,使用NNT Viewer软件对扫描所得DICOM数据进行后处理,以明确耳蜗与电极的相互关系。结果锥形束CT后处理Panorex模式显示:2例共同腔畸形患者耳蜗中的电极贴壁;其余17例大前庭水管、Mondini畸形、耳蜗发育不全患者耳蜗中的电极尖端均无弯折、末端无未进入耳蜗的电极点、中间弧度平滑。结论锥形束CT空间分辨力高,辐射剂量低,可用于评估不同类型内耳畸形患者人工耳蜗植入术后耳蜗内电极形态,尤其适用于儿童患者。
Objective To explore methods of evaluating morphological information of cochlea electrode in post cochlear implantation patients with inner ear malformation.Methods A total of 19 patients with severe to profound sensorineural hearing loss received cochlear implantation during 1 Jul. 2017 and 31 Jan. 2018 were enrolled. All the patients had a cone-beam CT scanning of the operated side 1 or 2 days after operation. The NNT Viewer was employed to analyze the original DICOM data of CBCT scanning to evaluate the morphological information.Results The cochlear implantation was bilateral at the same time in 2 patients while there were 4 left side implantations and 13 right side. There were 10 enlarged vestibular aqueduct cases, 6 mondini malformation cases, 2 common cavity cases and 1 case of cochlear hypoplasia with Charge syndrome. In the Panorex mode of NNT Viewer, all the 2 common cavity cases had wall adherent electrodes, and there were 17 cases of no tips fold and uninserted electrode point.Conclusion Cone-beam CT has high spatial resolution and low radiation dosage, which can be used to evaluate the morphology of cochlear electrodes in patients with different types of inner ear malformations after cochlear implantation, especially in children.
Objective To explore methods of evaluating morphological information of cochlea electrode in post cochlear implantation patients with inner ear malformation.Methods A total of 19 patients with severe to profound sensorineural hearing loss received cochlear implantation during 1 Jul. 2017 and 31 Jan. 2018 were enrolled. All the patients had a cone-beam CT scanning of the operated side 1 or 2 days after operation. The NNT Viewer was employed to analyze the original DICOM data of CBCT scanning to evaluate the morphological information.Results The cochlear implantation was bilateral at the same time in 2 patients while there were 4 left side implantations and 13 right side. There were 10 enlarged vestibular aqueduct cases, 6 mondini malformation cases, 2 common cavity cases and 1 case of cochlear hypoplasia with Charge syndrome. In the Panorex mode of NNT Viewer, all the 2 common cavity cases had wall adherent electrodes, and there were 17 cases of no tips fold and uninserted electrode point.Conclusion Cone-beam CT has high spatial resolution and low radiation dosage, which can be used to evaluate the morphology of cochlear electrodes in patients with different types of inner ear malformations after cochlear implantation, especially in children.
引文
1 Sennaroglu L,Bajin MD.Classification and current management of inner ear malformations[J].Balkan Med J,2017,5:397.
2 Zhou H,Sun X,Chen Z,et al.Evaluation of cochlear implantation in children with inner ear malformation[J].B-ENT,2014,4:265.
3 Mylanus EA,Rotteveel LJ,Leeuw RL.Congenital malformation of the inner ear and pediatric cochlear implantation[J].Otol Neurotol,2004,3:308.
4 Kraaijenga VJ,Smit AL,Stegeman I,et al.Factors that influence outcomes in cochlear implantation in adults,based on patient-related characteristics-a retrospective study[J].Clin Otolaryngol,2016,5:585.
5 Francis HW,Buchman CA,Visaya JM,et al.Surgical factors in pediatric cochlear implantation and their early effects on electrode activation and functional outcomes[J].Otol Neurotol,2008,4:502.
6 Yuan YY,Song YS,Chai CM,et al.Intraoperative CT-guided cochlear implantation in congenital ear deformity[J].Acta Otolaryngol,2012,9:951.
7 McHugh K.CT scanning in children and risk of cancer:what three large-scale studies have demonstrated[J].Radiat Prot Dosimetry,2015,1～4:10.
8 王振常.锥形束CT在颞骨影像的应用展望[J].中华医学杂志,2018,23:1809.
9 Kapila SD,Nervina JM.CBCT in orthodontics:assessment of treatment outcomes and indications for its use[J].Dentomaxillofac Radiol,2015,1:20140282.
2 Zhou H,Sun X,Chen Z,et al.Evaluation of cochlear implantation in children with inner ear malformation[J].B-ENT,2014,4:265.
3 Mylanus EA,Rotteveel LJ,Leeuw RL.Congenital malformation of the inner ear and pediatric cochlear implantation[J].Otol Neurotol,2004,3:308.
4 Kraaijenga VJ,Smit AL,Stegeman I,et al.Factors that influence outcomes in cochlear implantation in adults,based on patient-related characteristics-a retrospective study[J].Clin Otolaryngol,2016,5:585.
5 Francis HW,Buchman CA,Visaya JM,et al.Surgical factors in pediatric cochlear implantation and their early effects on electrode activation and functional outcomes[J].Otol Neurotol,2008,4:502.
6 Yuan YY,Song YS,Chai CM,et al.Intraoperative CT-guided cochlear implantation in congenital ear deformity[J].Acta Otolaryngol,2012,9:951.
7 McHugh K.CT scanning in children and risk of cancer:what three large-scale studies have demonstrated[J].Radiat Prot Dosimetry,2015,1～4:10.
8 王振常.锥形束CT在颞骨影像的应用展望[J].中华医学杂志,2018,23:1809.
9 Kapila SD,Nervina JM.CBCT in orthodontics:assessment of treatment outcomes and indications for its use[J].Dentomaxillofac Radiol,2015,1:20140282.