预测听神经瘤手术中听力保留的术前因素的敏锐度。

Acuteness of preoperative factors to predict hearing preservation in acoustic neuroma surgery.

作者信息

Ferber-Viart C, Laoust L, Boulud B, Duclaux R, Dubreuil C

机构信息

Audiovestibular Exploration and ENT Unit, Claude Bernard Lyon I University, Lyon South Hospital, France.

出版信息

Laryngoscope. 2000 Jan;110(1):145-50. doi: 10.1097/00005537-200001000-00026.

DOI:10.1097/00005537-200001000-00026

PMID:10646731

Abstract

OBJECTIVES

To determine in patients with acoustic neuromas the predictive factors of hearing preservation according to clinical, radiological, and electrophysiological parameters and to evaluate, for each of these predictive factors, the percentage of patients with preserved hearing.

STUDY DESIGN

The study involved 107 candidates for hearing preservation attempt. Mean age was 49.7 +/- 11.4 years. Quantitative and qualitative parameters were prospectively studied. Quantitative parameters were age, duration of functional complaints, hearing loss assessed by pure tone and speech audiometry, and auditory brainstem responses (ABRs). Qualitative parameters (expressed in percentage of presence) were sex, functional complaints, vestibular deficit revealed by vestibular testings, well-shaped ABRs, wave I, III, or V of ABRs, and transient evoked otoacoustic emissions (TEOAEs).

METHODS

Patients were divided into two groups according to whether their hearing was preserved (52.3%) or not preserved (47.7%). First, quantitative and qualitative factors were compared between both groups to identify predictive factors. Second, all patients were considered together and the percentage of hearing preservation was determined according to the presence of each predictive factor.

RESULTS

The results confirmed the predictive value of classic parameters such as preoperative hearing level, radiological data, and trace of ABRs. They also emphasized the predictive role of other parameters such as short duration of hearing loss, presence of wave III in ABRs, and presence of TEOAEs.

CONCLUSIONS

The size of the tumor and the preoperative hearing levels are longstanding predictive factors of hearing preservation in acoustic neuroma surgery, and candidates for hearing preservation are therefore now selected according to these factors. This study added more recent predictive factors and, among the 10 factors identified as predictive, the most relevant to hearing preservation were the presence of TEOAEs (69.7%), short duration of hearing loss (66.7%), and presence of wave III in ABRs (66.7%).

摘要

目的

根据临床、放射学和电生理参数，确定听神经瘤患者听力保留的预测因素，并评估这些预测因素中每一个因素下听力保留患者的百分比。

研究设计

该研究纳入了107名尝试保留听力的患者。平均年龄为49.7±11.4岁。对定量和定性参数进行前瞻性研究。定量参数包括年龄、功能障碍持续时间、通过纯音和言语测听评估的听力损失以及听性脑干反应（ABR）。定性参数（以出现的百分比表示）包括性别、功能障碍、前庭测试显示的前庭功能缺陷、形态良好的ABR、ABR的I波、III波或V波以及瞬态诱发耳声发射（TEOAEs）。