评估头部创伤后上半规管裂开(SSCD)出现症状的患者。
病例系列评估创伤后出现SSCD的患者。
完成了一系列病例评估创伤后出现SSCD的患者。来自三个学术医学中心的数据进行了评估,包括以下内容:成像,视频眼震描记术(VNG)/前庭诱发肌源性电位(VEMP)测试,听力评估,和手术修复。结果测量包括以下内容:1)音频前庭症状的描述,2)平均术前和术后纯音平均值(PTA),单词识别得分(WRS),和空气骨间隙(ABG)。
共纳入14例患者,其中86%为男性。大约43%的患者在影像学上发现双侧SSCD,57%的患者追求手术管理。最常见的症状包括搏动性耳鸣(93%),尸检(79%),听力损失(64%)。大约36%的患者接受了VNG/VEMP测试,83.3%的人表现出异常结果。症状侧的平均听力测量结果包括38.0dB的空气传导PTA,骨传导PTA为24.3dB,81%的WRS,和17.9dB的ABG。在接受手术的患者中(57%),空气传导PTA没有显著变化,骨传导PTA,或WRS(P>0.05)。然而,ABG改善(术前=22.8dB,术后=9.7dB;P=.005).
头部创伤可能是SSCD综合征的增强事件。这项研究提出了一个假设,即这些患者在创伤前可能有潜在的影像学SSCD,创伤性事件增加前庭内或颅内压,揭示SSCD综合征。
4喉镜,131:E2810-E2818,2021年。
To evaluate patients who become symptomatic from superior semicircular canal dehiscence (SSCD) following head trauma.
Case series assessing patients presenting with SSCD after a trauma.
A case series was completed assessing patients presenting with SSCD after trauma. Data from three academic medical centers were evaluated, including the following: imaging, videonystagmography (VNG)/vestibular evoked myogenic potential (VEMP) testing, audiometric assessment, and surgical repair. Outcome measures included the following: 1) Description of audio-vestibular symptoms, 2) mean pre- and post-operative pure tone average (PTA), word recognition score (WRS), and air bone gap (ABG).
A total of 14 patients were included; 86% were male. Approximately 43% were found to have bilateral SSCD on imaging, with 57% of patients pursuing surgical management. The most common presenting symptoms included pulsatile tinnitus (93%), autophony (79%), and hearing loss (64%). Approximately 36% of patients underwent VNG/VEMP testing, with 83.3% of those demonstrating abnormal results. The mean audiometric findings on the symptomatic side included an air-conduction PTA of 38.0 dB, bone-conduction PTA of 24.3 dB, WRS of 81%, and ABG of 17.9 dB. Among patients who underwent surgery (57%), there was no significant change in the air-conduction PTA, bone-conduction PTA, or WRS (P > .05). However, there was an improvement in the ABG (preoperative = 22.8 dB versus postoperative = 9.7 dB; P = .005).
Head trauma may be a potentiating event for SSCD syndrome. This study advances the hypothesis that these patients likely have underlying radiographic SSCD prior to their trauma, and a traumatic event increases in intra-vestibular or intracranial pressures, unmasking SSCD syndrome.
4 Laryngoscope, 131:E2810-E2818, 2021.