比较经乳突入路与中颅窝开颅术患者的结局,并进行封堵和/或表面置换以修复上半规管裂开。结果措施包括症状解决,听力,手术时间,住院,并发症,和修订率。
多中心回顾性队列研究.
三个三级神经学中心。
纳入了2006年至2017年在3个神经中心接受上管裂开修复的所有成年患者。通过图表审查收集的人口统计学和耳科病史。成像,听力数据,和前庭诱发的肌源性电位测量也被收集用于分析。
总共68名患者(74耳)被纳入研究。21例患者接受了中颅窝开颅手术修复(平均年龄,47.9年),47人接受了乳突修复术(平均年龄,48.0年)。两组之间的年龄或性别分布没有显着差异。与中颅窝开颅手术组相比,经乳突组的住院时间明显缩短,复发率较低(3.8%vs33%)。两组都经历了噪声性眩晕的改善,尸检,脉动性耳鸣,和非特异性眩晕。组间症状缓解无显著差异。此外,两组间听力测量结果无显著差异.
经乳突入路和中颅窝开颅术修复上管裂开的方法均可在最小风险下缓解症状。与中颅窝开颅手术相比,经乳突入路住院时间短,复发率低。
To compare outcomes for patients undergoing a transmastoid approach versus a middle fossa craniotomy approach with plugging and/or resurfacing for repair of superior semicircular canal dehiscence. Outcome measures include symptom resolution, hearing, operative time, hospital stay, complications, and revision rates.
Multicenter retrospective comparative cohort study.
Three tertiary neurotology centers.
All adult patients undergoing repair for superior canal dehiscence between 2006 and 2017 at 3 neurotology centers were included. Demographics and otologic history collected by chart review. Imaging, audiometric data, and vestibular evoked myogenic potential measurements were also collected for analysis.
A total of 68 patients (74 ears) were included in the study. Twenty-one patients underwent middle fossa craniotomy repair (mean age, 47.9 years), and 47 underwent transmastoid repair (mean age, 48.0 years). There were no significant differences in age or sex distribution between the groups. The transmastoid group experienced a significantly shorter duration of hospitalization and lower recurrence rate as compared with the middle fossa craniotomy group (3.8% vs 33%). Both groups experienced improvement in noise-induced vertigo, autophony, pulsatile tinnitus, and nonspecific vertigo. There was no significant difference among symptom resolution between groups. Additionally, there was no significant difference in audiometric outcomes between the groups.
Both the transmastoid approach and the middle fossa craniotomy approach for repair of superior canal dehiscence offer symptom resolution with minimal risk. The transmastoid approach was associated with shorter hospital stays and lower recurrence rate as compared with the middle fossa craniotomy approach.