Smith I M, Turnbull L W, Sellar R J, Murray J A, Best J J
Department of Otolaryngology, Royal Infirmary, Edinburgh, UK.
Clin Otolaryngol Allied Sci. 1990 Apr;15(2):167-71. doi: 10.1111/j.1365-2273.1990.tb00451.x.
In many centres the diagnosis of acoustic neuromas relies on a preliminary screening protocol. The current method is a combination of caloric tests, tomography of the internal auditory meati and brain stem evoked response audiometry (BSERA) with 2 positive results indicating the need for further investigation. This protocol, although sensitive lacks specificity and results in a high incidence of normal CT air meatograms. As this procedure is associated with a significant morbidity, we have devised a 'weighted' system of scoring to avoid subjecting large numbers of normal patients to CT air meatography. The proposed system has been derived from screening 61 patients with unilateral sensorineural hearing loss, 24 of whom had an acoustic neuroma. This method reduced the false positive rate of CT air meatography from 68%, using the 2 out of 3 criteria, to 18%, whilst the false negative incidence remained at 8%.
在许多医疗中心，听神经瘤的诊断依赖于初步筛查方案。目前的方法是将冷热试验、内听道断层扫描和脑干诱发反应测听法（BSERA）相结合，若三项中有两项结果呈阳性，则表明需要进一步检查。该方案虽然敏感度高，但缺乏特异性，导致正常CT内听道造影的发生率较高。由于此检查会带来显著的发病率，我们设计了一种“加权”评分系统，以避免让大量正常患者接受CT内听道造影检查。该提议的系统源自对61例单侧感音神经性听力损失患者的筛查，其中24例患有听神经瘤。此方法将依据三项标准中的两项来判断的CT内听道造影假阳性率从68%降至18%，而假阴性发生率仍为8%。
