耳蜗大小评估在人工耳蜗植入手术中的应用价值

文献信息

中文摘要

背景： 许多使用3D Slicer的研究增强了作者对内耳解剖变异的理解。然而，尚无单一报告分析耳蜗大小与耳蜗导管长度之间的相关性。
方法： 对164个结构正常耳蜗的高分辨率计算机断层扫描（HRCT）图像进行重建和阈值分割。重建图像获得了A、B、C和D值、耳蜗高度（CH）、耳蜗导管总长度（CDL）、基底转1/2长度（180° CDL）以及基底转全长（360° CDL）的测量值。对这些耳蜗参数在感音神经性听力损失（SNHL）患者与骨导正常（NBC）听力个体之间进行分析和比较。
结果： 本研究纳入82只SNHL患者耳，数量与NBC耳蜗相同。年龄和侧别对耳蜗尺寸无显著影响，两组中男性耳蜗均大于女性。除C值和180° CDL外，所有其他耳蜗参数在组间存在差异，提示SNHL患者耳蜗存在一定程度的微小畸形。A值、B值和CH均与耳蜗导管长度呈正相关，其中B值的相关性最高。
结论： SNHL患者通常伴有不同程度的轻度耳蜗畸形。个体间耳蜗大小的差异提示需要个性化人工耳蜗植入。A、B和D值以及CH测量值可预测CDL，从而指导确定最佳植入电极插入深度。

英文摘要

BACKGROUND: Numerous studies using 3D Slicer have enhanced the authors' understanding of anatomical variations in the inner ear. Yet, there is no single report that has analyzed the correlation between cochlear size and cochlear duct length.
METHODS: High-resolution computed tomography (HRCT) images of 164 structurally normal cochleae underwent reconstruction and threshold segmentation. The reconstructed images yielded measurements of values A, B, C, and D, cochlear height (CH), total cochlear duct length (CDL), length of the 1/2 basal turn (180° CDL), and full length of the basal turn (360° CDL). These cochlear parameters were analyzed and compared between patients with sensorineural hearing loss (SNHL) and individuals with normal bone-conduction (NBC) hearing.
RESULTS: In this study, 82 ears were included in patients with SNHL, the same quantity as NBC cochlear. Age and side showed no significant effect on cochlear dimensions, with males exhibiting larger cochleae than females in both groups. Except for C-value and 180° CDL, all other cochlear parameters differed between groups, indicating a degree of micro-malformation in cochleae of SNHL patients. The A-value, B-value, and CH all showed a positive correlation with cochlear duct length, and the highest correlation was observed for the B-value.
CONCLUSION: Patients with SNHL are usually accompanied by varying degrees of mild cochlear deformity. The difference in the size of the cochlea between individuals suggests the need for personalized cochlear implantation. The A, B, and D values and CH measurement values can predict CDL, thus guiding the determination of the best implant electrode insertion depth.