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频繁的牙科 X 射线检查是否会增加前庭神经鞘瘤的风险?

Are frequent dental x-ray examinations associated with increased risk of vestibular schwannoma?

机构信息

Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA, USA.

出版信息

J Neurosurg. 2012 Dec;117 Suppl:78-83. doi: 10.3171/2012.5.GKS12615.

Abstract

OBJECT

The authors evaluated the potential role of environmental risk factors, including exposure to diagnostic or therapeutic radiation and to wireless phones that emit nonionizing radiation, in the etiology of vestibular schwannoma (VS).

METHODS

A total of 343 patients with VSs who underwent Gamma Knife surgery performed between 1997 and 2007 were age and sex matched to 343 control patients from the outpatient degenerative spinal disorders service at the University of Pittsburgh Medical Center. The authors obtained information on previous exposure to medical radiation, use of wireless phone technologies, and other environmental factors thought to be associated with the development of a VS. Conditional multivariate logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

RESULTS

After adjusting for race, education, cigarette smoking, alcohol consumption, occupational exposure to noise, use of cell phones, and family history of cancer, the authors identified only a single factor that was associated with a higher risk of VS: individuals exposed to dental x-rays once a year (aOR = 2.27, 95% CI = 1.01-5.09) or once every 2-5 years (aOR = 2.65, 95% CI = 1.20-5.85), compared with those exposed less than once every 5 years. Of interest, a history of exposure to radiation related to head or head-and-neck computed tomography was associated with a reduced risk of VS (aOR = 0.52, 95% CI = 0.30-0.90). No relationship was found between the use of cell phones or cordless phones and VS.

CONCLUSIONS

Patients with acoustic neuromas reported significantly more exposure to dental x-rays than a matched cohort control group. Reducing the frequency of dental x-ray examinations may decrease the potential risk of VS.

摘要

目的

作者评估了环境风险因素的潜在作用,包括诊断或治疗辐射以及发射非电离辐射的无线电话的暴露,这些因素在前庭神经鞘瘤(VS)的病因学中可能发挥作用。

方法

作者将 1997 年至 2007 年间接受伽玛刀手术的 343 例 VS 患者与匹兹堡大学医学中心门诊退行性脊柱疾病服务的 343 例对照患者按年龄和性别匹配。作者获得了有关以前接受过医疗辐射、使用无线电话技术以及其他被认为与 VS 发生相关的环境因素的信息。使用条件多变量逻辑回归来估计调整后的优势比(aOR)和 95%置信区间(CI)。

结果

在调整了种族、教育程度、吸烟、饮酒、职业性噪声暴露、手机使用和癌症家族史等因素后,作者仅发现一个因素与 VS 风险增加相关:每年接受一次牙科 X 射线照射的个体(aOR = 2.27,95%CI = 1.01-5.09)或每 2-5 年接受一次 X 射线照射的个体(aOR = 2.65,95%CI = 1.20-5.85),而每年接受 X 射线照射少于一次的个体。有趣的是,有头部或头颈部 CT 扫描相关辐射暴露史的患者 VS 风险降低(aOR = 0.52,95%CI = 0.30-0.90)。未发现手机或无绳电话的使用与 VS 之间存在关系。

结论

听神经瘤患者报告的牙科 X 射线照射次数明显多于匹配的对照组。减少牙科 X 射线检查的频率可能会降低 VS 的潜在风险。

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