Baker Aaron, Fanelli David, Kanekar Sangam, Isildak Huseyin
*Division of Otolaryngology-Head and Neck Surgery, Department of Surgery †The Pennsylvania State University, College of Medicine ‡Department of Radiology, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Otol Neurotol. 2016 Oct;37(9):1366-9. doi: 10.1097/MAO.0000000000001172.
Bone-anchored hearing aid has been shown to be effective in hearing rehabilitation for conductive loss or single-sided deafness. Current FDA guidelines allow implantation in patients over 5 years old. This guideline is at least partially due to concern for thickness of bone stock at the implant site. We aim to investigate whether temporal bone thickness should be a deterrent to implantation in those younger than five.
A retrospective review of high-resolution temporal bone computed tomographies (CTs) comparing measurements between ears with chronic disease and controls.
Single institution tertiary care center.
One hundred patients between 1 and 5.99 years had temporal bone CTs performed between 2000 and 2009. Patients with chronic ear disease were identified by ICD-9 code, as well as confirmation by review of the imaging.
INTERVENTION(S): None.
Temporal bone thickness was measured on axial CT slices at a point 1 cm posterior to the sigmoid sinus, at the superior margin of the bony canal.
Average thickness was greater than 3 mm in all age groups. No significant difference was found between age groups, or between normal ears and ears with chronic disease (3.5 mm versus 3.3 mm, p = 0.21) when compared individually.
This data shows pediatric temporal bone thickness is frequently greater than the recommended 3 mm, even in patients as young as one. Anatomically, concerns regarding temporal bone thickness in patients younger than five could be reliably addressed with imaging typically obtained in workup of hearing loss.
骨锚式助听器已被证明在传导性听力损失或单侧耳聋的听力康复中有效。美国食品药品监督管理局（FDA）目前的指南允许在5岁以上的患者中植入。该指南至少部分是由于担心植入部位骨量的厚度。我们旨在研究颞骨厚度是否应成为5岁以下儿童植入的阻碍因素。
对高分辨率颞骨计算机断层扫描（CT）进行回顾性分析，比较患有慢性疾病的耳朵与对照耳朵的测量结果。
单一机构的三级医疗中心。
2000年至2009年间，100名年龄在1至5.99岁之间的患者进行了颞骨CT检查。通过国际疾病分类第九版（ICD-9）编码以及影像学复查来确定患有慢性耳部疾病的患者。
无。
在乙状窦后方1厘米处、骨管上缘的轴向CT切片上测量颞骨厚度。
所有年龄组的平均厚度均大于3毫米。在各年龄组之间，以及正常耳朵与患有慢性疾病的耳朵之间进行单独比较时，未发现显著差异（3.5毫米对3.3毫米，p = 0.21）。
该数据表明，即使是1岁的患者，小儿颞骨厚度也经常大于推荐的3毫米。从解剖学角度来看，对于5岁以下患者的颞骨厚度问题，可以通过听力损失检查中通常获得的影像学检查可靠地解决。
