Boston, Mass. From the Departments of Plastic and Oral Surgery and Genetics, Children's Hospital Boston.
Plast Reconstr Surg. 2011 May;127(5):2014-2020. doi: 10.1097/PRS.0b013e31820cf16a.
Hearing loss has been described in Apert syndrome but is poorly documented in other craniosynostosis disorders.
The authors retrospectively reviewed the audiologic and otologic records of patients with Saethre-Chotzen syndrome to define the incidence, type, and extent of hearing loss. Only patients with documented audiologic examinations were included. Hearing loss was categorized by American Speech-Language-Hearing Association guidelines (i.e., mild, 26 to 40 dB; moderate, 41 to 55 dB; moderate/severe, 56 to 70 dB; severe, 71 to 90 dB; and profound, >90 dB).
Twenty-nine patients met inclusion criteria. Mean age at initial audiologic evaluation was 6.7 years (range, 0.7 to 24.5 years). Seventeen patients (59 percent) had at least one abnormal audiogram; in 15 patients, the deficit was mild. Eight patients demonstrated sensorineural hearing loss. Five cases resolved and, thus, had been mischaracterized. Six patients had conductive hearing loss on at least one examination; follow-up testing in four patients revealed normal hearing. Two patients had unspecified hearing loss by sound field method. One patient had mixed hearing loss on consecutive audiograms. Twenty-one patients (72 percent) had normal hearing on their last audiogram.
Most patients with Saethre-Chotzen syndrome had hearing loss at some point during childhood. This was typically mild and correlated with middle ear abnormality and eustachian tube dysfunction. Usually, the hearing deficit resolved. Early mischaracterization of mixed hearing loss or conductive hearing loss as sensorineural hearing loss was common.
Apert 综合征患者存在听力损失,但其他颅缝早闭疾病患者的听力损失情况记录较少。
作者回顾性分析了 Saethre-Chotzen 综合征患者的听力和耳科学记录,以明确听力损失的发生率、类型和程度。仅纳入有明确听力检查记录的患者。根据美国言语-语言-听力协会(American Speech-Language-Hearing Association)指南对听力损失进行分类(即轻度,26 至 40dB;中度,41 至 55dB;中重度,56 至 70dB;重度,71 至 90dB;极重度,>90dB)。
29 例患者符合纳入标准。初次听力评估的平均年龄为 6.7 岁(0.7 至 24.5 岁)。17 例患者(59%)至少有 1 次异常听力图;其中 15 例患者为轻度听力损失。8 例患者为感音神经性听力损失。5 例听力损失已缓解,故此前的诊断有误。6 例患者至少有 1 次检查为传导性听力损失;4 例患者的随访检查显示听力正常。4 例患者的声导抗检查为不明原因的听力损失。1 例患者连续听力图显示混合性听力损失。21 例患者(72%)最后一次听力检查正常。
大多数 Saethre-Chotzen 综合征患者在儿童期的某个时间点存在听力损失。听力损失通常为轻度,与中耳异常和咽鼓管功能障碍有关。听力缺陷通常会缓解。早期将混合性听力损失或传导性听力损失误诊为感音神经性听力损失的情况较为常见。