儿童特发性感音神经性听力损失的诊断范式
A diagnostic paradigm for childhood idiopathic sensorineural hearing loss.
作者信息
Preciado Diego A, Lim Lynne H Y, Cohen Aliza P, Madden Colm, Myer David, Ngo Chris, Bradshaw John K, Lawson Louise, Choo Daniel I, Greinwald John H
机构信息
Center for Hearing and Deafness Research, Division of Pediatric Otolaryngology--Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Ohio 45229-3039, USA.
出版信息
Otolaryngol Head Neck Surg. 2004 Dec;131(6):804-9. doi: 10.1016/j.otohns.2004.06.707.
OBJECTIVE
Our objective was to determine the diagnostic yield of laboratory testing, radiological imaging, and GJB2 mutation screening in a large cohort of patients with differing severities of idiopathic sensorineural hearing loss (SNHL).
DESIGN AND SETTING
We undertook a retrospective study of patients presenting with SNHL at our institution from 1993 to 2002.
RESULTS
Laboratory testing had an extremely low yield. Patients with unilateral SNHL had a significantly higher imaging yield than those with bilateral. The diagnostic yield of GJB2 screening was significantly higher in patients with severe to profound SNHL than in those with less severe SNHL. However, a relatively large number of patients with mild to moderate SNHL had positive GJB2 screens.
CONCLUSIONS
Based on diagnostic yields, we propose a cost-effective stepwise diagnostic paradigm to replace the more commonly used and costly simultaneous testing approach.
EBM RATING
C.
目的
我们的目的是确定在一大群患有不同严重程度特发性感音神经性听力损失（SNHL）的患者中，实验室检测、放射影像学检查和GJB2基因突变筛查的诊断率。
设计与背景
我们对1993年至2002年在我们机构就诊的SNHL患者进行了一项回顾性研究。
结果
实验室检测的诊断率极低。单侧SNHL患者的影像学诊断率显著高于双侧患者。重度至极重度SNHL患者的GJB2筛查诊断率显著高于轻度至中度SNHL患者。然而，相当数量的轻度至中度SNHL患者GJB2筛查呈阳性。
结论
基于诊断率，我们提出一种具有成本效益的逐步诊断模式，以取代更常用且成本更高的同步检测方法。
循证医学评级
C级。
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