普遍新生儿听力筛查中确诊耳聋者颞骨CT的影像学分析

目的：探讨普遍新生儿听力筛查中确诊为耳聋的婴幼儿颞骨高分辨率CT（HRCT）的影像学表现，以及对耳聋原因诊断的作用。方法：2005年1～12月，121400名新生儿参加上海市新生儿听力筛查，1077例2次筛查阳性者转至上海市儿童听力障碍诊治中心进一步行诊断性听力检查，其中184例被确诊为先天性聋的患儿接受颞骨HRCT检查，对此资料进行分析研究。结果：184例先天性聋患儿中颞骨HRCT发现解剖畸形者58例（31．5％），其中外耳畸形26例（44．8％），中耳畸形21例（36．2％），内耳畸形31例（53．4％）。内耳畸形包括Mondini畸形12例，共同腔畸形1例，前庭导水管扩大、不伴耳蜗畸形6例，前庭、半规管畸形10例，内听道异常5例。另外，单纯鼓室积液20例（10．8％）。结论：HRCT检查对婴幼儿耳聋原因的鉴别诊断和治疗有一定帮助。

A temporal bone CT study of the infants with hearing loss referred from universal newborn hearing screening

Objective:To explore the high resolution CT image of temporal bone in infants with hearing loss, and its value in evaluating the cause of hearing loss.Method:In 2005, 0.12 million newborns have been included in the hearing screening system in Shanghai, and 1077 infants have failed to pass the hearing screening. One hundred and eight four infants were diagnosed as congenital hearing loss from mild to profound. A temporal bone HRCT scanning was performed to these infants.Result: Among the 184 patients with congenital hearing loss, HRCT showed that 26 cases (14.1 %) were associated with external ear malformation,and 21 cases (11.4%) were associated with middle ear malformation, 31 cases (16.8%) associated with inner ear malformation . The patients with inner ear malformation included 12 cases with Mondini malformation, 1 case with common cavity malformation, 6 cases with large vestibule malformation, 5 cases with internal auditory canal abnormities, and 10 cases with vestibule,semicircular canals abnormities. In addition, there were 20 cases (10.8%)with fluid in middle ear.Conclusion:HRCT image play an important role in the differential diagnosis and treatment of infants with congenital hearing loss.