목적: Diffusion Tensor Imaging (DTI) is an advanced MRI technique that allows for the assessment of white matter microstructure by measuring fractional anisotropy (FA) and other diffusion properties. While conventional imaging techniques, such as CT and standard MRI, are commonly used to evaluate the temporal bone and cochlear nerve in patients with hearing loss, microstructural changes in the central auditory pathways often remain undetected in routine clinical practice. This study aimed to use Tract-Based Spatial Statistics (TBSS) to investigate white matter integrity in patients with severe-to-profound sensorineural hearing loss (SNHL) by analyzing FA across the whole brain. 방법:Patients with severe-to-profound bilateral SNHL who were candidates for cochlear implantation (CI) were included in this study. They were divided into two subgroups based on hearing thresholds (>60 dB and >70 dB) and were each compared separately with age- and sex-matched healthy controls (1:1 matching). DTI data were acquired using a 3T MRI scanner, and FA maps were generated. TBSS was applied for voxel-wise whole-brain analysis to assess white matter integrity. Group comparisons were performed using permutation-based inference with 5000 permutations and Threshold-Free Cluster Enhancement (TFCE) correction to identify significant FA differences. 결과:Nineteen patients with bilateral hearing loss >70 dB and their respective controls (p = 0.30, 0.74 for age and sex, respectively), as well as twenty-three patients with bilateral hearing loss >60 dB and their respective controls (p = 0.19, 0.92 for age and sex, respectively), were included. Voxel-wise analysis revealed significantly increased FA in the left Superior Longitudinal Fasciculus (SLF) in the >60 dB group and in the left Anterior Thalamic Radiation (ATR) in the >70 dB group compared to controls (p < 0.05, TFCE-corrected). 결론:This study suggests that SNHL may be associated with microstructural changes in white matter tracts, particularly in the left hemisphere. Patients with bilateral SNHL >60 dB exhibited FA differences in the SLF, a tract linked to auditory processing and sensory integration. In those with bilateral SNHL >70 dB, FA differences were observed in the ATR, which is associated with thalamocortical connectivity and cognitive functions. While these findings indicate structural differences in white matter associated with hearing loss severity, further research incorporating volumetric analyses of connected gray matter regions or functional MRI studies may provide a more comprehensive understanding of the neural changes associated with SNHL.