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Temporal bone imaging in osteogenesis imperfecta patients with hearing loss
Author(s) -
Swinnen Freya K. R.,
Casselman Jan W.,
Leenheer Els M. R.,
Cremers Cor W. R. J.,
Dhooge Ingeborg J. M.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23963
Subject(s) - medicine , audiogram , osteogenesis imperfecta , hearing loss , temporal bone , oval window , conductive hearing loss , cochlea , bone conduction , otosclerosis , magnetic resonance imaging , audiometry , audiology , radiology , anatomy , stapes , middle ear
Objectives/Hypothesis Osteogenesis imperfecta (OI) is an autosomal‐dominant connective‐tissue disorder, predominantly characterized by bone fragility. Conductive hearing loss develops in half of the OI patients and often progresses to mixed loss. Findings of computed tomography (CT) and magnetic resonance (MR) imaging of the temporal bone in the largest series of OI patients to date are presented and correlated with the audiograms. Study Design Retrospective case series. Methods CT images and audiograms of 17 hearing‐impaired OI patients, aged 9 to 67 years, were analyzed retrospectively. In four patients, MR imaging was performed as well. Imaging abnormalities were correlated with type and severity of hearing loss deduced from the audiograms. Results CT revealed fenestral hypodense foci in the fissula ante fenestram (25 of 33 ears), oval window (23 of 33 ears), and round window (20 of 33 ears). Retrofenestral hypodensities were observed, affecting the cochlear turns (16 of 33 ears), facial nerve canal (10 of 33 ears), or semicircular canals (6 of 33 ears), or appearing like the fourth turn of the cochlea (11 of 33 ears). The site of hypodensities corresponded to the type of hearing loss in 72.2% of the OI ears. The air‐bone gap and bone‐conduction thresholds showed significant positive associations with the number of affected fenestral ( P < .05) and retrofenestral structures ( P < .01), respectively. Gadolinium‐enhanced MR images demonstrated active lesions in three patients with mixed hearing loss or deafness. Conclusions The site of hypodensities on temporal bone CT images in OI corresponds to presence and type of hearing loss determined by audiometry. The more severe the hearing loss, the more affected temporal bone structures in OI. Level of Evidence 4. Laryngoscope, 123:1988–1995, 2013