摘要
目的:探讨功能性磁共振(fMRI)评价耳蜗前庭神经畸形患者是否有人工耳蜗植入指征的可能性。方法:对1例15岁双侧耳聋患者,在人工耳蜗植入前进行听力学、影像学检查及fMRI综合评估。结果:纯音测听和听觉脑干反应显示患者为双侧极重度感音神经性聋,瞬态诱发性耳声发射双侧均未引出。颞骨薄层CT显示内耳畸形(不全分隔Ⅰ型),MRI斜矢状位重建显示耳蜗前庭神经畸形。fMRI显示左耳给声,1000Hz100dBHL,右侧听皮层被激活;右耳给声,双侧听皮层均未见激活。左侧人工耳蜗植入术后1个月开机,患者对声音有反应。结论:结合听力学和影像学检查,fMRI可评估人工耳蜗植入候选者,尤其是在影像学检查显示患者耳蜗前庭神经发育畸形时,更是一种有效的评估方法。
Objective：To evaluate the feasibility of cochlear implantation by functional magnetic resonance imaging （fMRI） in a patient with cochleovestibular nerve hypoplasia.Method：Audiometry, radiological examination and fMRI of the auditory cortex were performed to a 15-year-old boy with bilateral hearing loss before cochlear implantation.Result：Results of pure tone audiometry and auditory brainstem responses showed profound sensorineural hearing loss（SNHL）.Transiently evoked otoacoustic emission was absent on both sides. High resolution computed tomography revealed the inner ear malformation（incomplete partition I） on both side. Oblique sagittal reconstruction in magnetic resonance imaging（MRI） showed the malformation of cochleovestibular nerve. fMRI demonstrated the activation of the right primary auditory cortex during 1-kHz monaural stimulation on the left side. No cortical activation appeared during the monaural right acoustic stimulation using the same sound pressure level. The child had subjective auditory reponse 1 month after cochlear implantation on his left side.Conclusion：fMRI would be an effective measure in the assessments for the cochlear implantation candidates, combining with audiometry and radiological examination, especially when MRI shows cochleovestibular nerve malformation in these patients.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第5期217-220,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
功能性磁共振
耳蜗前庭神经发育不良
人工耳蜗植入
听力损失
感音神经性
functional magnetic resonance image
cochleovestibular nerve hypoplasia
cochlear implantation
hearing loss
sensorineural
