背景:上半规管裂开(SSCD)是耳囊的裂开,通常位于上半规管上方。该数据库构成了迄今为止最大的SSCD患者系列。
目的:为了确定术前因素,如果有的话,在大型SSCD患者队列中有助于术后结局并评估症状缓解。
方法:单一机构,回顾性图表回顾收集的患者人口统计,术中发现,以及手术前后的症状.对不成对的分类变量进行Fisher精确t检验,显著性水平为p<0.05。
结果:进行了350例SSCD修复。中位年龄为52岁(范围:17-86岁,±6.4年),中位随访时间为4.6个月(范围:0.03-59.5个月,±6.8个月)。术前听力损失与女性性别显著相关(p=0.0028)。术前报告最多的症状是耳鸣(77.4%),头晕(74.0%),尸检(66.3%),扩增(63.7%),和不平衡(62.6%)。在接受单侧和双侧SSCD修复的患者之间,术后症状缓解率最高的是尸检(74.9%,p<0.001),扩增(77.3%,p=0.00027),高音(77.4%,p=0.023),听力(62.9%,p=0.0063),和头晕(54.6%,对于单侧SSCD修复的患者,p<0.001)。
结论:经中颅窝入路手术修复可显著解决听觉,前庭,SSCD患者的神经系统症状。尽管这是迄今为止最大的单一机构SSCD研究之一,未来的多机构,前瞻性研究将有助于验证这些结果。
BACKGROUND: Superior Semicircular Canal Dehiscence (SSCD) is a dehiscence of the otic capsule which normally lies over the superior semicircular canal. This database constitutes the largest series of SSCD patients to date.
OBJECTIVE: To determine what preoperative factors, if any, contribute to postoperative outcomes and evaluate symptom resolution in a large SSCD patient cohort.
METHODS: A single-institution, retrospective chart review collected patient demographics, intraoperative findings, and pre-and postoperative symptoms. Fisher\'s exact t-test was performed for unpaired categorical variables, with a significance level of p < 0.05.
RESULTS: 350 SSCD repairs were performed. The median age was 52 years (range: 17-86 years, ± 6.4 years), and the median follow-up duration was 4.6 months (range: 0.03-59.5 months, ± 6.8 months). Preoperative hearing loss was significantly associated with female sex (p = 0.0028). The most reported preoperative symptoms were tinnitus (77.4%), dizziness (74.0%), autophony (66.3%), amplification (63.7%), and disequilibrium (62.6%). Between patients who received unilateral versus bilateral SSCD repair, the greatest postoperative symptomatic resolution was seen in autophony (74.9%, p < 0.001), amplification (77.3%, p = 0.00027), hyperacusis (77.4%, p = 0.023), hearing (62.9%, p = 0.0063), and dizziness (54.6%, p < 0.001) for patients with unilateral SSCD repair.
CONCLUSIONS: Surgical repair via the middle cranial fossa approach can significantly resolve auditory, vestibular, and neurological symptoms of patients with SSCD. Although this is one of the largest single-institution SSCD studies to date, future multi-institutional, prospective studies would be beneficial to validate these results.