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1.
J Laryngol Otol ; 134(7): 603-609, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32713375

RESUMO

OBJECTIVE: This study aimed to evaluate the association between cochlear nerve canal dimensions and semicircular canal abnormalities and to determine the distribution of bony labyrinth anomalies in patients with cochlear nerve canal stenosis. METHOD: This was a retrospective study in which high-resolution computed tomography images of paediatric patients with severe-to-profound sensorineural hearing loss were reviewed. A cochlear nerve canal diameter of 1.5 mm or less in the axial plane was classified as stenotic. Semicircular canals and other bony labyrinth morphology and abnormality were evaluated. RESULTS: Cochlear nerve canal stenosis was detected in 65 out of 265 ears (24 per cent). Of the 65 ears, 17 ears had abnormal semicircular canals (26 per cent). Significant correlation was demonstrated between cochlear nerve canal stenosis and semicircular canal abnormalities (p < 0.01). Incomplete partition type II was the most common accompanying abnormality of cochlear nerve canal stenosis (15 out of 65, 23 per cent). CONCLUSION: Cochlear nerve canal stenosis is statistically associated with semicircular canal abnormalities. Whenever a cochlear nerve canal stenosis is present in a patient with sensorineural hearing loss, the semicircular canal should be scrutinised for presence of abnormalities.


Assuntos
Perda Auditiva Neurossensorial/etiologia , Canais Semicirculares/anormalidades , Doenças do Nervo Vestibulococlear/complicações , Adolescente , Criança , Pré-Escolar , Nervo Coclear/diagnóstico por imagem , Nervo Coclear/patologia , Constrição Patológica , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/patologia , Humanos , Lactente , Masculino , Estudos Retrospectivos , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/patologia , Tomografia Computadorizada por Raios X , Doenças do Nervo Vestibulococlear/diagnóstico por imagem , Doenças do Nervo Vestibulococlear/etiologia , Doenças do Nervo Vestibulococlear/patologia
2.
Clin Imaging ; 66: 42-53, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32450482

RESUMO

Ear malformations represent 50% of ear, nose and throat malformations. Ear malformations cause conductive hearing loss (CHL) and/or sensorineural hearing loss (SNHL) with a significant childhood disability worldwide. Early accurate diagnosis and treatment are mandatory to enhance language and speech development. Understanding the embryology of the ear explains the outcome of ototoxic prenatal insult according to the affected gestational age and the incidence of association among inner, middle, and external ear malformations. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations of the temporal bone are used in the evaluation of ear malformations. In this review article, the spectrum of ear malformations is discussed in detail with hints on the ear embryology, the ear radiological anatomy, and radiological determinant factors of operative reconstruction of ear anomalies.


Assuntos
Orelha Interna/anormalidades , Orelha Interna/diagnóstico por imagem , Criança , Feminino , Idade Gestacional , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Idioma , Imagem por Ressonância Magnética/efeitos adversos , Masculino , Ototoxicidade , Radiografia , Radiologistas , Radiologia , Osso Temporal/anormalidades , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
3.
Rev Assoc Med Bras (1992) ; 66(1): 74-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130385

RESUMO

OBJECTIVE: This study aims to investigate the application value of magnetic resonance (MR) hydrography of the inner ear in cochlear implantation. METHODS: 146 patients were enrolled. MR hydrography and spiral CT examinations for the intracranial auditory canal were performed before surgery, and all imaging results were statistically analyzed in order to explore the application value of MR hydrography of the inner ear in cochlear implantation. RESULTS: 146 patients (292 ears) were examined. Among these patients, 13 were diagnosed with abnormal vestibular aqueducts (20 ears) by MR hydrography, while five were diagnosed with this disease by CT; 15 patients were diagnosed with inner ear malformation (19 ears) by MR hydrography, while 11 were diagnosed by CT (four were misdiagnosed); five patients were diagnosed with internal acoustic canal stenosis (eight ears) by MR hydrography, while two were diagnosed by CT (three were misdiagnosed); and four patients were diagnosed with cochlear fibrosis (five ears) by MR hydrography, while four were diagnosed by CT (four ears). The correct rate of diagnosis was 77.40% (113/146) based on CT, while the rate was 93.84% (137/146) based on MR hydrography. CONCLUSIONS: MR hydrography imaging technique can be applied to the preoperative evaluation of cochlear implantation, providing accurate and reliable anatomic information on the inner membranous labyrinth and nerves in the internal acoustic canal and an accurate basis for the diagnosis of cochlear fibrosis and nerve development. This has a guiding significance for the selection of treatment schemes.


Assuntos
Implante Coclear/métodos , Orelha Interna/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Orelha Interna/cirurgia , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/cirurgia , Humanos , Lactente , Doenças do Labirinto/diagnóstico por imagem , Doenças do Labirinto/cirurgia , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Valores de Referência , Reprodutibilidade dos Testes , Tomografia Computadorizada Espiral/métodos , Adulto Jovem
4.
J Comput Assist Tomogr ; 44(3): 386-388, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32168082

RESUMO

PURPOSE: Incomplete partition III (IP-III) characterized by congenital mixed or sensorineural hearing loss is a rare genetic disease transmitted through X-linked inheritance. Incomplete partition III can be easily achieved based on pathognomonic computed tomography findings. The aims of this study were to investigate the otic capsule abnormalities in IP-III and to report irregular contour of membranous labyrinth and hypomineralized areas at otic capsule, which have not previously been described. MATERIALS AND METHODS: The otic capsule features of 10 subjects (8 affected patients, 1 of whom is a female; 2 carrier mothers), who were diagnosed on clinical and typical radiologic findings, were analyzed. RESULTS: All patients had typical IP-III as described in the literature. Seven of 10 patients had irregular contour. Seven of 10 patients demonstrated hypomineralized areas, which were very hypodense to normally develop otic capsule areas. One affected patients and 2 carrier mothers had a normal-looking membranous labyrinth contour and normal mineralization at otic capsule. CONCLUSIONS: We report for the first time the irregular contour of inner ear structures and hypodense otic capsule areas in patients with IP-III. We think that though speculative, abnormal development of the inner endosteal layer results in irregular contour of inner ear structures. Hypomineralized areas at otic capsule could be explained by abnormal development of middle enchondral layer due to reduced or absent vascular supply from middle ear mucosa during fetal life. These findings may be accepted as additional criteria of IP-III.


Assuntos
Orelha Interna , Perda Auditiva Neurossensorial , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Desmineralização Patológica Óssea/diagnóstico por imagem , Desmineralização Patológica Óssea/patologia , Criança , Pré-Escolar , Orelha Interna/anormalidades , Orelha Interna/diagnóstico por imagem , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Adulto Jovem
5.
BMC Med Genet ; 20(1): 198, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852434

RESUMO

BACKGROUND: Perrault syndrome is a genetically heterogenous, very rare disease, characterized clinically by sensorineural hearing loss, ovarian dysfunction and neurological symptoms. We present the case of a 33 years old female patient with TWNK-associated Perrault syndrome. The TWNK gene is coding the mitochondrial protein Twinkle and currently there are only two reports characterizing the phenotype of TWNK-associated Perrault syndrome. None of these publications reported about special brain MRI alterations and neuropathological changes in the muscle and peripheral nerves. CASE PRESENTATION: Our patients with TWNK-dependent Perrault syndrome had severe bilateral hypoacusis, severe ataxia, polyneuropathy, lower limb spastic paraparesis with pyramidal signs, and gonadal dysgenesis. Psychiatric symptoms such as depression and paranoia were present as well. Brain MRI observed progressive cerebellar hyperintensive signs associated with cerebellar, medulla oblongata and cervical spinal cord atrophy. Light microscopy of the muscle biopsy detected severe neurogenic lesions. COX staining was centrally reduced in many muscle fibers. Both muscle and sural nerve electron microscopy detected slightly enlarged mitochondria with abnormal cristae surrounded by lipid vacuoles. In the sural nerve, dystrophic axons had focally uncompacted myelin lamellae present. Genetic investigation revealed multiple mtDNA deletion and compound heterozygous mutations of the TWNK gene (c.1196 A > G, c.1358 G > A). CONCLUSION: This study demonstrates that TWNK associated Perrault syndrome has a much broader phenotype as originally published. The coexistence of severe hypoacusis, spastic limb weakness, ataxia, polyneuropathy, gonadal dysgensia, hyperintense signals in the cerebellum and the presence of the mtDNA multiple deletion could indicate the impairment of the TWNK gene. This is the first report about pyramidal tract involvement and cerebellar MRI alteration associated with TWNK-related Perrault syndrome.


Assuntos
DNA Helicases/genética , Disgenesia Gonadal 46 XX/genética , Perda Auditiva Neurossensorial/genética , Proteínas Mitocondriais/genética , Fenótipo , Adulto , Feminino , Disgenesia Gonadal 46 XX/diagnóstico por imagem , Disgenesia Gonadal 46 XX/patologia , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/patologia , Humanos , Imagem por Ressonância Magnética , Mutação
6.
Otolaryngol Head Neck Surg ; 161(6): 1027-1030, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31570055

RESUMO

OBJECTIVE: Unilateral vestibular weakness has considerable potential etiologies. One source is a vestibular schwannoma. This article evaluates, in the absence of other symptoms and signs, if unilateral vestibular weakness is an analogue to asymmetric sensorineural hearing loss and serves as an indication for lateral skull base imaging. STUDY DESIGN: Retrospective chart review. SETTING: Academic tertiary center. SUBJECTS AND METHODS: All patients undergoing caloric assessment between January 1, 2012, and June 30, 2018, were investigated. Patients with unilateral vestibular weakness (a left-right difference >25% on electronystagmography) were included in the study. A provincial encompassing image library was surveyed for potential adequate imaging (computed tomography internal auditory canal infused, magnetic resonance imaging [MRI] brain, MRI internal auditory canal) of the target population within the preceding 5 years. Presence/absence of vestibular schwannoma on imaging was determined. RESULTS: Of the 3531 electronystagmography reports reviewed during the period, 864 patients were identified with unilateral vestibular weakness. Of these, 542 had sufficient imaging, and 14 vestibular schwannomas were identified. Only 1 individual had a vestibular weakness in isolation, while the remaining 13 patients also suffered from documented sensorineural hearing loss that would have mandated MRI scanning. CONCLUSION: The results of our study suggest that, in isolation, vestibular weakness is an insufficient indicator for lateral skull base imaging.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Neuroma Acústico/diagnóstico por imagem , Vestíbulo do Labirinto/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes Calóricos , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/complicações , Seleção de Pacientes , Estudos Retrospectivos
7.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(10): 734-740, 2019 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-31606985

RESUMO

Objective: The radiological and audiological results of patients with hearing loss associated with enlarged vestibular aqueduct (EVA) were analyzed statistically to explore the association between them. Methods: In this retrospective study, we screened 64 patients (128 ears) with EVA diagnosed in the Department of Otorhinolaryngology, Shengjing Hospital of China Medical University from January 2012 to June 2016, who met the inclusion criteria and the exclusion criteria at the same time, including 37 males (74 ears) and 27 females (54 ears), aged from 6 months to 17 years, all of whom showed varying degrees of sensorineural hearing loss (SNHL). The imaging observations included the midpoint measurement (MP) and the operculum measurement(OP) of the temporal bone HRCT, the long signal area cross-sectional area (ES(L)), the short signal area cross-sectional area (ES(S)), as well as the largest total signal area cross-sectional area (ES(T)) of the endolymphatic sac(ES) of the cochlear MRI. The audiological observations included collecting detailed medical history and subjective and/or objective audiological examinations to determine the character and degree of hearing loss. According to the progress and changes of hearing loss, they were divided into hearing stability group (86 ears) and fluctuation/progression group (42 ears). SPSS22.0 statistical software was used to carry out statistical analysis of the imaging measurement results. Results: The sizes of MP and OP were smaller in the stable group than those in the fluctuating/progressive group, and the difference was statistically significant (P<0.05). For ES(L), ES(S) or ES(T), there was no significant difference between the stable group and the fluctuating/progressive group (P>0.05). For the 13 patients with asymmetric hearing loss, the sizes of MP, OP, ES(L), ES(S) or ES(T) were not significantly different between the mild side and the serious side (P>0.05). For the ears whose ES(L)/ES(S) was>2 or the ES(S)/ES(L) was>2, the proportion was not significantly different between the stable group and the fluctuating/progressive group (P>0.05). Conclusions: For patients with EVA,the smaller the enlarged vestibular aqueduct is,the more likely it is congenital severe sensorineural hearing loss. Patients with significantly enlarged vestibular aqueduct often exhibit volatility/progressive hearing loss. The degree of enlargement of the endolymphatic vessels and endolymphatic sac is not related to the degree of hearing loss. For EVA patients with asymmetric hearing loss, the mild or serious side of hearing loss is random, which is not affected by the degree of enlargement of the vestibular aqueduct and endolymphatic sac. The degree of hearing loss in patients with EVA is not related to the ratio of ES(L)/ES(S).


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Aqueduto Vestibular/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Testes Auditivos , Humanos , Lactente , Masculino , Estudos Retrospectivos
9.
Br J Radiol ; 92(1104): 20190513, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31529977

RESUMO

MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.


Assuntos
Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias da Base do Crânio/diagnóstico por imagem , Artefatos , Osso e Ossos/diagnóstico por imagem , Tecido Conjuntivo/diagnóstico por imagem , Meios de Contraste , Imagem de Difusão por Ressonância Magnética , Hidropisia Endolinfática/diagnóstico por imagem , Gadolínio , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Súbita/diagnóstico por imagem , Humanos , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética/tendências
10.
Mult Scler Relat Disord ; 35: 170-175, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31400558

RESUMO

Sudden sensorineural hearing loss (SSHL) is a rare manifestation of multiple sclerosis, typically appearing in the early stages of the disease, especially in female subjects. SSHL is produced by the involvement of auditory tract, vestibulocochlear nerve and possibly cochlear structures and rarely due to a single lesion. The authors report the case of a young woman in which the onset of multiple sclerosis presented with SSHL caused by a pontine lesion. Oligoclonal bands in the cerebrospinal fluid (CSF) were absent at the disease onset and appeared during disease progression. Immunophenotyping of cells showed low cellularity of CD19+ cells in the CSF and expression of CD38+ on the majority of CD19+, CD20+ B cells in the peripheral blood, suggesting that many of them were mature B lymphocytes.


Assuntos
Linfócitos B , Doenças Desmielinizantes/complicações , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Súbita/etiologia , Esclerose Múltipla/complicações , Ponte/diagnóstico por imagem , Adulto , Doenças Desmielinizantes/sangue , Doenças Desmielinizantes/líquido cefalorraquidiano , Doenças Desmielinizantes/diagnóstico por imagem , Progressão da Doença , Feminino , Perda Auditiva Neurossensorial/sangue , Perda Auditiva Neurossensorial/líquido cefalorraquidiano , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Súbita/sangue , Perda Auditiva Súbita/líquido cefalorraquidiano , Perda Auditiva Súbita/diagnóstico por imagem , Humanos , Esclerose Múltipla/sangue , Esclerose Múltipla/líquido cefalorraquidiano , Esclerose Múltipla/diagnóstico por imagem , Bandas Oligoclonais/líquido cefalorraquidiano
11.
Neuroradiol J ; 32(6): 420-425, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31337256

RESUMO

Cryopyrin-associated periodic syndrome is a hereditary inflammatory disorder encompassing a wide spectrum of clinical phenotypes. This disorder has been associated with mutation of the NLRP3 gene coding for cryopyrin, which leads to overproduction of interleukin-1. The condition causes relapsing bouts of inflammation involving multiple organ systems, including the central nervous system, and, if untreated, can lead to long-term debilitating effects. A literature review revealed only a few brief descriptions of magnetic resonance imaging findings in cryopyrin-associated periodic syndrome patients. We describe serial magnetic resonance imaging findings in an 11-year-old female with clinically diagnosed cryopyrin-associated periodic syndrome who presented with intermittent headaches, progressive sensorineural hearing loss, fevers, and abdominal pain. The magnetic resonance imaging showed progressively worsening low T2 signal in the cochlea, cochlear enhancement, and leptomeningeal enhancement. We also describe some previously unreported findings in this syndrome, including cranial nerve and cauda equina enhancement.


Assuntos
Cauda Equina/diagnóstico por imagem , Sistema Nervoso Central/diagnóstico por imagem , Cóclea/diagnóstico por imagem , Nervos Cranianos/diagnóstico por imagem , Síndromes Periódicas Associadas à Criopirina/diagnóstico por imagem , Malformação de Arnold-Chiari/complicações , Malformação de Arnold-Chiari/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Criança , Síndromes Periódicas Associadas à Criopirina/complicações , Progressão da Doença , Feminino , Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Meninges/diagnóstico por imagem , Medula Espinal/diagnóstico por imagem
12.
J Coll Physicians Surg Pak ; 29(8): 753-756, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358098

RESUMO

OBJECTIVE: To analyse application value of CT and MRI in the diagnosis of large vestibular aqueduct syndrome (LVAS) in children. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of ENT, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, China, from January 2014 to January 2018. METHODOLOGY: Children with LVAS confirmed by CT, with different degrees of hearing loss and vertigo, less than 18 years, with complete clinical and imaging data, were included. Children under 2 years, with other serious diseases in organs, poor compliance, with other genetic diseases, were excluded. CT and MRI diagnosis data of 25 cases (50 diseased ears) with LVAS were retrospectively analysed. CT and MRI imaging results were observed. Midpoint and external aperture diameter of vestibular aqueduct in CT, MRI diagnosis were compared. RESULTS: CT images showed visible vestibular aqueducts in different degrees of enlargement and bone defect shadow in different shapes. Vestibular aqueducts were enlarged in the 3D image after VR reconstruction. MRI images showed higher signal of endolymphatic sac and endolymphatic ducts in varying degrees of enlargement, and endolymphatic sac was enlarged in the 3D image after VR reconstruction. Midpoint diameter of vestibular aqueduct was larger in CT than in MRI diagnosis (p<0.001), external aperture diameter of the vestibular aqueduct was smaller in CT than in MRI diagnosis (p<0.001). CONCLUSION: LVAS children diagnosed as vestibular aqueduct enlargement by CT should receive MRI scan to further clarify the enlargement degree of endolymphatic sac and endolymphatic duct to increase the diagnosis rate.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Aqueduto Vestibular/anormalidades , Aqueduto Vestibular/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , China , Feminino , Humanos , Masculino , Estudos Retrospectivos , Síndrome
13.
J Int Adv Otol ; 15(2): 330-332, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31287431

RESUMO

Facial nerve schwannomas are rare benign neoplasms. We report a case of a 60-year-old woman who initially presented with vestibular complaints. Magnetic resonance imaging (MRI) revealed a facial nerve schwannoma centered on the right geniculate ganglion extending in the labyrinthine segment. The patient consulted again after 2 months because she developed a sudden and severe right-sided sensorineural hearing loss. MRI showed no progression or pathological enhancement in the membranous labyrinth. A cone beam computed tomography (CT) of the temporal bone was performed and revealed a large erosion at the region of the geniculate ganglion in open communication with the middle turn of the cochlea. This case report demonstrates the importance of CT in facial nerve schwannomas for evaluating the impact on the surrounding structures.


Assuntos
Doenças Cocleares/etiologia , Neoplasias dos Nervos Cranianos/complicações , Doenças do Nervo Facial/complicações , Neurilemoma/complicações , Doenças Cocleares/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Doenças do Nervo Facial/diagnóstico por imagem , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Humanos , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem
14.
PLoS One ; 14(5): e0217682, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150482

RESUMO

OBJECTIVES: We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF). METHODS: Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction. RESULTS: Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025). CONCLUSIONS: The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.


Assuntos
Paralisia Facial/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva/fisiopatologia , Osso Temporal/fisiopatologia , Adulto , Idoso , Cóclea/fisiopatologia , Nervo Facial/diagnóstico por imagem , Nervo Facial/fisiopatologia , Paralisia Facial/diagnóstico por imagem , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/fisiopatologia , Perda Auditiva/diagnóstico por imagem , Perda Auditiva/etiologia , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Humanos , Masculino , Processo Mastoide/fisiopatologia , Pessoa de Meia-Idade , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/fisiopatologia , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Vertigem/diagnóstico por imagem , Vertigem/fisiopatologia
15.
Int J Dev Neurosci ; 76: 34-40, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173823

RESUMO

Patients with sensorineural hearing loss (SNHL) tend to show language delay, executive functioning deficits, and visual cognitive impairment, even after intervention with hearing amplification and cochlear implants, which suggest altered brain structures and functions in SNHL patients. In this study, we investigated structural brain MRI in 30 children with SNHL (18 mild to moderate [M-M] SNHL and 12 moderately severe to profound [M-P] SNHL) by comparing gender- and age-matched normal controls (NC). Region-based analyses did not show statistically significant differences in volumes of the cerebrum, basal ganglia, cerebellum, and the ventricles between SNHL and NC. On surface-based analyses, the global and lobar cortical surface area, thickness, and volumes were not statistically significantly different between SNHL and NC participants. Regional surface areas, cortical thicknesses, and cortical volumes were statistically significantly smaller in M-P SNHL compared to NC in the left middle occipital cortex, and left inferior occipital cortex after a correction for multiple comparisons using random field theory (p < 0.02). These regions were identified as areas known to be related to high level visual cognition including the human middle temporal area, lateral occipital area, occipital face area, and V8. The observed regional decreased thickness in M-P SNHL may be associated with dysfunctions of visual cognition in SNHL detectable in a clinical setting.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico por imagem , Lobo Occipital/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Lateralidade Funcional , Perda Auditiva Neurossensorial/complicações , Humanos , Imagem por Ressonância Magnética , Masculino , Transtornos da Visão/complicações , Transtornos da Visão/diagnóstico por imagem
16.
Otol Neurotol ; 40(6): e569-e574, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31157719

RESUMO

OBJECTIVE: The purpose of the present study was to detect structural changes in the brains of patients with sensorineural hearing loss (SNHL) by combining voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS). METHODS: Thirty-five patients with SNHL (mean age: 39.72 ±â€Š1.81 yr) and 23 age-matched control subjects (mean age: 39.83 ±â€Š1.96 yr) were assessed using three-dimensional, T1-weighted imaging, and diffusion tensor imaging. TBSS and VBM analyses were performed to evaluate grey matter (GM) volume changes and white matter (WM) alternations, as measured by mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD). RESULTS: VBM showed decreased GM volume in patients with SNHL in the fusiform gyrus of the right temporal lobe and right middle occipital gyrus. TBSS revealed WM integrity changes, including decreased FA and RD and increased RD in several WM regions. However, MD showed no significant difference between patients with SNHL and age-matched controls. CONCLUSION: Patients with SNHL showed smaller GM volume and WM integrity changes in several regions.


Assuntos
Encéfalo/patologia , Substância Cinzenta/patologia , Perda Auditiva Neurossensorial/patologia , Substância Branca/patologia , Adulto , Encéfalo/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Feminino , Substância Cinzenta/diagnóstico por imagem , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Imageamento Tridimensional/métodos , Masculino , Substância Branca/diagnóstico por imagem
18.
J Int Adv Otol ; 15(1): 77-82, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31058598

RESUMO

OBJECTIVES: Capture the human inner-ear malformation types in 3D by segmenting the inner-ear structures from clinical CT (computed tomography) and MR (magnetic resonance) image datasets. Volumetric analysis was done to find the variations in the volume of cochlear part alone from complete inner-ear followed by 3D printing from the 3D segmented models. MATERIALS AND METHODS: Using 3D slicer freeware, the complete inner-ear structures were segmented from anonymized CT and MR image by setting a tight grey-scale threshold to avoid capturing unwanted structures followed by volumetric analysis of the cochlear part alone. 3D printing was done using Form labs desktop 3D printer. RESULTS: We identified 2x normal anatomy (NA) cochlea, 1x enlarged vestibular aqueduct syndrome (EVAS), 3x incomplete partition (IP) type-I, 4x IP type-II, 3x IP type-III, 5x common cavity (CC) and 5x cochlear hypoplasia (CH). 3D segmented models along with the 3D printed models showed huge variation in size, shape and the anatomy among the image data-sets analyzed. Volumetric analysis showed that on average, volume of CC was above 150mm3, volume of CH fell below 80mm3, Volume of NA, EVAS and IP-I were all around 85-105mm3 whereas the volume of IP-II was around 50mm3. CONCLUSION: Visualizing human inner-ear malformation types in 3D both as computer models and as 3D printed models is a whole-new experience as demonstrated in this study. The volumetric analysis showed a huge variation among the volume of cochlear part alone among the malformation types.


Assuntos
Cóclea/anormalidades , Orelha Interna/anormalidades , Orelha Interna/diagnóstico por imagem , Impressão Tridimensional/instrumentação , Cóclea/diagnóstico por imagem , Simulação por Computador , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Aqueduto Vestibular/anormalidades , Aqueduto Vestibular/diagnóstico por imagem , Aqueduto Vestibular/patologia
19.
Radiology ; 291(3): 814-818, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31116692

RESUMO

History A 1-year-old boy was referred for cochlear implant assessment after he received a diagnosis of bilateral profound sensorineural hearing loss at neonatal hearing screening shortly after birth. The child was born at term via uneventful delivery, and there was no history of familial hearing loss or maternal illness. Tympanic membranes were normal, and hearing loss was confirmed with auditory brainstem testing, which showed no response from either ear. Hearing aids were provided from 3 months of age, but no behavioral responses were noted when these were worn. He was also noted to have some mild developmental delay throughout his 1st year of life and was slow to crawl, roll over, and stand up. Physical examination showed no syndromic features or physical abnormalities. Ophthalmology confirmed normal vision and visual movements but bilateral anesthetic corneas. He had corneal abrasions due to minor repeated corneal trauma, and left-sided tarsorraphy was performed at 6 months. Facial nerve function, swallow, and voice quality were normal. To assess suitability for a cochlear implant, the patient underwent MRI of the temporal lobe and brain and thin-section CT of the temporal bones. The patient subsequently underwent left cochlear implantation.


Assuntos
Malformações do Sistema Nervoso , Tegmento Pontino , Implante Coclear , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/cirurgia , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Malformações do Sistema Nervoso/diagnóstico por imagem , Malformações do Sistema Nervoso/patologia , Tegmento Pontino/anormalidades , Tegmento Pontino/diagnóstico por imagem , Tegmento Pontino/patologia , Osso Temporal/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
20.
Dev Cogn Neurosci ; 38: 100654, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31129460

RESUMO

Due to heightened level of neuroplasticity, there is a sensitive period (2-4 years after birth) that exists for optimal central auditory development. Using diffusion tensor imaging combined with resting-state functional connectivity (rsFC) analysis, this study directly investigates the structural connectivity alterations of the whole brain white matter (WM) and the functional reorganization of the auditory network in infants with sensorineural hearing loss (SNHL) during the early sensitive period. 46 bilateral profound SNHL infants prior to cochlear implantation (mean age, 17.59 months) and 33 healthy controls (mean age, 18.55 months) were included in the analysis. Compared with controls, SNHL infants showed widespread WM alterations, including bilateral superior longitudinal fasciculus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, right corticospinal tract, posterior thalamic radiation and left uncinate fasciculus. Moreover, SNHL infants demonstrated increased rsFC between left/right primary auditory cortex seeds and right insula and superior temporal gyrus. In conclusion, this study suggests that SNHL in the early sensitive period is associated with diffuse WM alterations that mainly affect the auditory and language pathways. Furthermore, increased rsFC in areas mainly associated with auditory and language networks may potentially reflect reorganization and compensatory activation in response to auditory deprivation during the early sensitive period.


Assuntos
Córtex Auditivo/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Perda Auditiva Neurossensorial/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Rede Nervosa/diagnóstico por imagem , Córtex Auditivo/fisiopatologia , Pré-Escolar , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Lactente , Masculino , Rede Nervosa/fisiopatologia , Plasticidade Neuronal/fisiologia
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