背景:鼓膜完整的传导性或混合性听力损失是一组以相似的临床症状为特征的疾病。明确的诊断取决于探索性鼓室手术的发现。锥形束计算机断层扫描(CBCT)具有巨大的中耳成像潜力。这项研究评估了CBCT对鼓膜完整的传导性或混合性听力损失的诊断价值。
方法:CBCT和高分辨率计算机断层扫描(HRCT)成像数据收集自2020年10月至2023年5月在我院接受传导性或混合性听力损失治疗的鼓膜完整患者。分析CBCT和HRCT的影像学特点及诊断价值。
结果:共纳入137例符合纳入标准并接受CBCT的患者,包括89例耳硬化症,41听骨链中断,7伴有鼓室硬化。CBCT清晰显示中耳焦点,例如位于fissulaantefenestram的低密度病变,听骨链畸形或脱位,鼓室钙化灶.耳硬化症的曲线下面积值,听骨链中断,鼓室硬化分别为0.934、0.967和0.850。CBCT比HRCT更有效地显示透镜状过程,cendostapeal关节,和stapes脚踏板。
结论:中耳的CBCT显示出更高质量的成像,以改善鼓膜完整的传导性或混合性听力损失的诊断。因此,建议CBCT用于进一步研究中耳的非炎症性疾病,但在HRCT上没有特殊发现。
BACKGROUND: Conductive or mixed hearing loss with an intact tympanic membrane is a group of diseases characterized by similar clinical symptoms. Definitive diagnosis depends on the findings of exploratory tympanic surgery. Cone-beam computed tomography (CBCT) has great potential for middle ear imaging. This study evaluated the diagnostic value of CBCT for conductive or mixed hearing loss with an intact tympanic membrane.
METHODS: CBCT and high-resolution computed tomography (HRCT) imaging data were collected from patients with an intact eardrum who received medical treatment in our hospital for conductive or mixed hearing loss from October 2020 to May 2023. The imaging characteristics and diagnostic values of CBCT and HRCT were analyzed.
RESULTS: A total of 137 patients who met the inclusion criteria and underwent CBCT were enrolled, including 89 with otosclerosis, 41 with ossicular chain interruption, and 7 with tympanosclerosis. CBCT clearly displayed a middle ear focus, such as low-density lesions located in the fissula ante fenestram, ossicular chain malformation or dislocation, and tympanic calcification foci. The area under the curve values for otosclerosis, ossicular chain interruption, and tympanic sclerosis were 0.934, 0.967, and 0.850, respectively. CBCT was more effective than HRCT for visualizing the lenticular process, incudostapedial joint, and stapes footplate.
CONCLUSIONS: CBCT of the middle ear demonstrated higher-quality imaging to improve the diagnosis of conductive or mixed hearing loss with an intact tympanic membrane. Therefore, CBCT is recommended for further investigation of noninflammatory diseases of the middle ear with no special findings on HRCT.