• Korean Journal of Radiology
• /
• 제20권5호
• /
• pp.823-829
• /
• 2019

Objective: To summarize the high-resolution computed tomography (HRCT) and magnetic resonance imaging (HRMRI) features of duplicated internal auditory canals (DIACs). Materials and Methods: Ear HRCT data of 64813 patients with sensorineural hearing loss (SNHL), obtained between August 2009 and November 2017, were reviewed. Among these patients, 12 (13 ears) were found to have DIACs, 9 of whom underwent HRMRI. Their images were evaluated by two otoradiologists. Results: The rate of occurrence of DIAC among SNHL patients was 0.019% (12/64813). The internal auditory canals of 13 ears were divided into double canals by complete (n = 6) and incomplete (n = 7) bony septa, with varied orientations ranging from horizontal to approximately vertical. All of the anterosuperior canals extended into the facial nerve (FN) canal, except for 1, which also extended to the vestibule. The posteroinferior canals ended in the cochlea and vestibule, except for 2, which also connected to the FN canals. Magnetic resonance images revealed that 77.8% (7/9) and 22.2% (2/9) of vestibulocochlear nerves (VCNs) were aplastic and hypoplastic, respectively. Furthermore, 88.9% (8/9) of FNs were normal, except for 1, which was hypoplastic. All of the affected ears also had other ear anomalies: a narrow, bony cochlear nerve canal was the most common other anomaly, accounting for 92.3% (12/13). Malformations of other systems were not found. Conclusion: Double-canal appearance is a characteristic finding of DIAC on HRCT, and it is usually accompanied by other ear anomalies. The VCN usually appears aplastic, with a normal FN, on HRMRI.

• 한국융합학회논문지
• /
• 제10권3호
• /
• pp.73-79
• /
• 2019

머리 측두부 디지털 영상 및 통신 표준 영상을 이용한 외이도 길이, 상하 굴곡각도, 내 외경 비율에 따른 음향민감도를 외이도 모델링으로 시뮬레이션하고 측정하였다. 실험은 인간 가청주파수 기준으로 200Hz씩 증가하면서 1 파스칼의 압력으로 일정하게 전달된 주파수를 고막 음향크기로 나타내어 그 측정값들을 선형과 이차곡선 회귀분석으로 나타내었다. 그 결과 외이도 길이는 길수록, 외 내경 둘레의 비율은 높을수록 낮은 주파수에서 빠른 음향적 반응을 나타내었다. 회귀분석을 이용한 메타모델의 음향민감도 상관관계는 외이도 길이가 77%, 외 내경 비율 5%의 영향으로 나타났지만 상하 굴곡각도는 특별한 관계를 나타내지 못하였다. 이로써 인간의 청각음향 민감도는 외이도 길이가 길수록, 외 내경 둘레의 비율 차이가 높을수록 낮은 주파수에서 빠르게 반응하는 인자임을 알 수 있었다.

• Investigative Magnetic Resonance Imaging
• /
• 제25권3호
• /
• pp.197-200
• /
• 2021

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

• Journal of Korean Neurosurgical Society
• /
• 제58권2호
• /
• pp.141-143
• /
• 2015

Among the distal anterior inferior cerebellar artery (AICA) aneurysms, a unique aneurysm at the meatal loop inside the internal auditory meatus is extremely rare. The authors report a case of surgically treated total intrameatal AICA aneurysm. A 62-year-old female patient presenting with sudden bursting headache and neck pain was transferred to our department. Computed tomography and digital subtraction angiography showed subarachnoid hemorrhage at the basal, prepontine cistern and an aneurysm of the distal anterior inferior cerebellar artery inside the internal auditory meatus. Surgery was performed by retrosigmoid craniotomy with unroofing of the internal auditory meatus. The aneurysm was identified between the seventh and eighth cranial nerve in the meatus and was removed from the canal and clipped with a small straight Sugita clip. After operation the patient experienced transient facial paresis and tinnitus but improved during follow up.

• Journal of Korean Neurosurgical Society
• /
• 제57권4호
• /
• pp.292-294
• /
• 2015

Vestibular schwannoma (VS) usually present the widening of internal auditory canal (IAC), and these bony changes are typically limited to IAC, not extend to temporal bone. Temporal bone invasion by VS is extremely rare. We report 51-year-old man who revealed temporal bone destruction beyond IAC by unilateral VS. The bony destruction extended anteriorly to the carotid canal and inferiorly to the jugular foramen. On histopathologic examination, the tumor showed typical benign schwannoma and did not show any unusual vascularity or malignant feature. Facial nerve was severely compressed and distorted by tumor, which unevenly eroded temporal bone in surgical field. Vestibular schwannoma with atypical invasion of temporal bone can be successfully treated with combined translabyrinthine and lateral suboccipiral approach without facial nerve dysfunction. Early detection and careful dissection of facial nerve with intraoperative monitoring should be considered during operation due to severe adhesion and distortion of facial nerve by tumor and eroded temporal bone.

• 한국방사선학회논문지
• /
• 제11권6호
• /
• pp.467-473
• /
• 2017

의료용 디지털 영상 및 통신 표준과 3차원 의료 영상 프로그램을 이용하여 외이도의 해부학적 특징들을 비교하였다. 실험은 연령과 성별이 다른 63귀의 영상을 이용하여 외이도의 횡축 길이, 내부 직경 둘레, 상하부 굴곡 각도를 측정한 후 비교하였다. 실험 결과 외이도 형태는 연령과 성별 뿐 만 아니라 동일인의 좌.우 에서도 다르게 나타났다. 성별 비교에서 남자 35귀, 여자 28귀에 대한 평균 길이는 남자가 4.75mm 길게 나타났다. 외이도 직경 둘레는 하부 굴곡 각도를 중심으로 내측이 외측 보다 평균 37.2% 감소된 형태로 나타났다. 상하부 굴곡 각도는 상부가 평균적으로 $25.7^{\circ}$ 높았으나 4귀에서 하부 각도가 높고, 연령이 낮은(4~14세) 8귀에서 상하부 굴곡 각도 차이가 크게 나타났다. 이는 성장하면서 외이도 굴곡 모양이 변화됨을 나타냈다. 본 연구는 기존 귀본 채취를 통한 간접 측정과 물리적 방법에 의한 직접 측정과 비교하여 안전성과 정밀성을 높일 수 있는 방법이다. 이는 3차원 의료 영상 표현 기술이 실제에 가깝게 표현할 수 있는 기술 향상 때문이며 더 발전하여 외이도 형태의 표준화 연구에도 활용될 수 있는 측정 방법이라 판단된다.

• Imaging Science in Dentistry
• /
• 제51권3호
• /
• pp.313-321
• /
• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

• Radiation Oncology Journal
• /
• 제27권4호
• /
• pp.173-180
• /
• 2009

목 적: 본 연구에서는 외이도 및 중이에 생긴 편평상피암의 치료에 있어서 방사선치료의 역할에 대해 알아보고자 한다. 대상 및 방법: 1981년부터 2007년까지 외이도 및 중이에 생긴 편평상피암으로 치료 받은 총 35명의 기록을 후향적으로 분석하였다. 13명은 방사선치료 단독, 4명은 수술 단독, 18명은 수술 방사선 병용 요법으로 치료하였다. 방사선치료 단독군에서 조사된 중앙 방사선량은 66 Gy (범위, 39~70 Gy)이었고, 수술 방사선 병용 치료군에서는 61.2 Gy (범위, 44~70 Gy)를 조사하였다. 치료 방법에 따른 질병특이생존율 및 무국소진행생존율을 비교하였으며 추적관찰기간은 0.2~14.6년(중앙값 2.8년)이었다. 결 과: 3년 질병특이생존율 및 무국소진행생존율은 각각 80%, 63%이었다. 질병특이생존율에 관한 단변량 분석에서 전신수행상태 및 잔여 종양의 유무가 통계적인 유의성을 보여주었고, 무국소진행생존율에는 전신수행상태 및 조직학적 등급이 유의하였다. 치료 후 잔여 종양은 방사선 단독 치료군(69%)에서 수술 방사선 병용 치료군(28%)에 비해 많이 관찰 되었다. 비록 양군간에 질병특이생존율은 통계학적인 차이를 보이지 않았지만 방사선 단독 치료군에서 병용 치료군에 비해 조기 국소 재발의 빈도가 높았다. 결 론: 외이도 및 중이의 편평상피암 환자에서 방사선 단독 치료는 질병특이생존율에 있어서 수술 방사선 병용 치료와 유사한 결과를 보여주었다. 그러나 낮은 국소 제어율을 높이기 위한 치료 방법의 향상이 있어야 할 것으로 생각된다.

• Journal of Audiology & Otology
• /
• 제24권4호
• /
• pp.198-203
• /
• 2020

Background and Objectives: We sought to evaluate the diagnostic and prognostic value of measurable parameters of internal auditory canal (IAC) magnetic resonance imaging (MRI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Subjects and Methods: We retrospectively reviewed the patients with ISSNHL who underwent IAC MRI from January 2008 to March 2019. Measurable parameters of IAC MRI, such as the diameter of the IAC, bony cochlear nerve canal, and cross-sectional area of the cochlear nerve, were measured by a single examiner. These parameters were then compared between the affected and healthy sides. Inner-ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis were also evaluated. The relationship between the surveyed parameters and the diagnosis of ISSNHL was assessed. Results: A total of 208 patients with ISSNHL were included. The measured parameters of IAC MRI were not different between the affected and healthy sides and were also not associated with the diagnosis of ISSNHL. However, inner-ear abnormalities of IAC MRI in ISSNHL displayed a significant association with worse hearing before and after treatment. An age that was older than 40 years also correlated with poorer outcomes. Further, inner-ear abnormalities were more frequently detected when IAC MRI was performed early after ISSNHL onset. Conclusions: Patients with ISSNHL and inner ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis identified via IAC MRI may experience poorer hearing outcomes. To detect such abnormal findings, it is recommended to perform IAC MRI early after the onset of ISSNHL.

• 대한청각학회지
• /
• 제24권4호
• /
• pp.198-203
• /
• 2020

Background and Objectives: We sought to evaluate the diagnostic and prognostic value of measurable parameters of internal auditory canal (IAC) magnetic resonance imaging (MRI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Subjects and Methods: We retrospectively reviewed the patients with ISSNHL who underwent IAC MRI from January 2008 to March 2019. Measurable parameters of IAC MRI, such as the diameter of the IAC, bony cochlear nerve canal, and cross-sectional area of the cochlear nerve, were measured by a single examiner. These parameters were then compared between the affected and healthy sides. Inner-ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis were also evaluated. The relationship between the surveyed parameters and the diagnosis of ISSNHL was assessed. Results: A total of 208 patients with ISSNHL were included. The measured parameters of IAC MRI were not different between the affected and healthy sides and were also not associated with the diagnosis of ISSNHL. However, inner-ear abnormalities of IAC MRI in ISSNHL displayed a significant association with worse hearing before and after treatment. An age that was older than 40 years also correlated with poorer outcomes. Further, inner-ear abnormalities were more frequently detected when IAC MRI was performed early after ISSNHL onset. Conclusions: Patients with ISSNHL and inner ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis identified via IAC MRI may experience poorer hearing outcomes. To detect such abnormal findings, it is recommended to perform IAC MRI early after the onset of ISSNHL.