Relationship between sudden sensorineural hearing loss and facial auditory nerve and anterior inferior cerebellar artery vascular loop in the internal auditory tract MRI
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摘要: 目的 探讨内听道MRI中面听神经及小脑前下动脉血管袢与突发性感音神经性听力损失(SSNHL)之间的相关性。方法 回顾性分析2019年1月-2021年1月就诊于中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科的SSNHL患者144例(实验组)及健康体检者36例72耳(对照组)，分别采集两组患者的内听道MRI数据，收集所有研究对象的相关临床资料，并分析各指标与听力损失之间的相关性。结果 单侧SSNHL患耳听神经与周围血管的距离关系与健耳及对照组健耳比较差异均有统计学意义(P < 0.05)，双侧SSNHL患耳听神经与周围血管的距离关系与对照组健耳比较差异有统计学意义(P < 0.05)，单侧SSNHL患耳血管袢分型与健耳及对照组健耳比较差异无统计学意义(P>0.05)，双侧SSNHL患耳血管袢分型与对照组健耳比较差异无统计学意义(P>0.05)，单侧SSNHL和双侧SSNHL患耳听力分级、分型与血管袢分型、面听神经与周围血管的距离关系比较差异均无统计学意义(P>0.05)。结论 听神经与周围血管最近处的距离与SSNHL存在相关性，血管压迫听神经可能出现SSNHL。Abstract: Objective To investigate the correlation between the facial auditory nerve and anterior inferior cerebellar artery vascular loop in MRI of the internal auditory meatus and idiopathic sudden sensorineural hearing loss.Methods This retrospective study enrolled 144 patients with idiopathic sudden sensorineural hearing loss(SSNHL)(experimental group) and 36 healthy subjects with 72 ears(control group), who attended the Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA from January, 2019 to January, 2021. The magnetic resonance imaging(MRI) data of the internal auditory meatus and clinical data were collected and compared between the two groups.Results The distance between the auditory nerve and the peripheral vessels in the unilateral SSNHL-affected ear was significantly different from that in the contralateral ears and that in the healthy ears of the control group (P < 0.05). The distance between the auditory nerve and the peripheral vessels in both ear affected by bilateral SSNHL was significantly different from that in the healthy ears of the control group (P < 0.05). There was no significant difference in radiological grading of vascular loops between the ears affected by unilateral SSNHL and the contralateral ears and the healthy ear of the control group (P>0.05). No statistically significant differences in radiological grading of vascular loops were found between both ears with bilateral SSNHL and the healthy ears in the control group(P>0.05). The severity of hearing loss, audiometric configuration, radiological grading of vascular loops and the distance between the facial auditory nerve and peripheral vessels were not significantly different between the affected ears in unilateral SSNHL and both ears in bilateral SSNHL (P>0.05).Conclusion SSNHL is associated with the distance between the auditory nerve and the nearest peripheral vessel. SSNHL may occur when the vessel compresses the auditory nerve.
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Key words:
- hearing loss, sudden /
- internal auditory tract /
- auditory nerve
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表 1 双侧SSNHL患耳与对照组健耳分析
对照耳(n=72) 患耳(n=94) χ2 P值 血管袢分型 Ⅰ型 45(62.5) 56(59.6) Ⅱ型 24(33.3) 32(34.0) 0.421 0.867 Ⅲ型 3(4.2) 6(6.4) 面神经与周围血管的距离关系 压迫 3(4.2) 11(11.7) 接触 24(33.3) 29(30.9) 3.774 0.285 邻近 6(8.3) 11(11.7) 远离 39(54.2) 43(45.7) 听神经与周围血管的距离关系 压迫 3(4.2) 57(60.6) 接触 12(16.7) 14(14.9) 邻近 15(20.8) 2(2.1) 63.902 0.000 远离 42(58.3) 21(22.3) 
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表 2 单侧SSNHL患耳与对照组健耳分析
对照耳(n=72) 患耳(n=97) χ2 P 血管袢分型 Ⅰ型 45(62.5) 61(62.9) Ⅱ型 24(33.3) 32(33.0) 0.089 1.000 Ⅲ型 3(4.2) 4(4.1) 面神经与周围血管的距离关系 压迫 3(4.2) 12(12.4) 接触 24(33.3) 44(45.4) 8.459 0.036 邻近 6(8.3) 8(8.2) 远离 39(54.2) 33(34.0) 听神经与周围血管的距离关系 压迫 3(4.2) 63(64.9) 接触 12(16.7) 17(17.5) 邻近 15(20.8) 0(0) 79.032 0.000 远离 42(58.3) 17(17.5)
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表 3 单侧SSNHL健耳与患耳分析
健耳(n=97) 患耳(n=97) χ2 P值 血管袢分型 Ⅰ型 72(74.2) 61(62.9) Ⅱ型 22(22.7) 32(33.0) 2.938 0.243 Ⅲ型 3(3.1) 4(4.1) 面神经与周围血管的距离关系 压迫 11(11.3) 12(12.4) 接触 40(41.2) 44(45.4) 0.801 0.850 邻近 7(7.2) 8(8.2) 远离 39(40.2) 33(34.0) 听神经与周围血管的距离关系 压迫 46(47.4) 63(64.9) 接触 25(25.8) 17(17.5) 邻近 7(7.2) 0(0) - 0.007 远离 19(19.6) 17(17.5)
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表 4 单侧SSNHL听力损失程度分级的分析
轻度 中度 重度 极重度 χ2 P值 血管袢分型 Ⅰ型 25 10 10 16 Ⅱ型 13 5 7 7 - 0.887 Ⅲ型 1 1 0 2 面神经与周围血管的距离关系 压迫 5 1 2 4 接触 15 10 8 11 - 0.853 邻近 3 0 2 3 远离 16 5 5 7 听神经与周围血管的距离关系 压迫 25 10 13 15 接触 8 4 2 3 邻近 0 0( 0 0 - 0.772 远离 6 2 2 7
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表 5 单侧SSNHL听力曲线分型的分析
低频 高频 平坦 全聋 χ2 P值 血管袢分型 Ⅰ型 12 22 11 16 Ⅱ型 4 17 4 7 - 0.204 Ⅲ型 0 0 2 2 面神经与周围血管的距离关系 压迫 2 5 1 4 接触 7 17 9 1 - 0.932 邻近 2 3 0 3 远离 5 14 7 7 听神经与周围血管的距离关系 压迫 9 29 10 15 接触 2 7 5 3 邻近 0 0 0 0 - 0.193 远离 5 3 2 7
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表 6 双侧SSNHL听力损失程度分级的分析
轻度 中度 重度 极重度 χ2 P值 血管袢分型 Ⅰ型 18 23 8 7 Ⅱ型 15 9 6 2 - 0.137 Ⅲ型 2 0 2 2 面神经与周围血管的距离关系 压迫 6 2 2 1 接触 11 11 4 3 - 0.176 邻近 8 3 0 0 远离 10 16 10 7 听神经与周围血管的距离关系 压迫 26 13 10 8 接触 1 9 3 1 临近 0 2 0 0 - 0.059 远离 8 8 3 2
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表 7 双侧SSNHL听力曲线分型的分析
低频 高频 平坦 全聋 χ2 P 血管袢分型 Ⅰ型 2 27 20 7 Ⅱ型 1 19 10 2 - 0.094 Ⅲ型 1 0 4 1 面神经与周围血管的距离关系 压迫 1 7 2 1 接触 0 16 10 3 - 0.187 邻近 1 8 2 0 远离 2 15 20 6 听神经与周围血管的距离关系 压迫 3 31 16 7 接触 0 5 8 1 邻近 0 1 1 0 - 0.756 远离 1 9 9 2
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