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小儿上半规管裂:病例展示与系统综述

Pediatric superior semicircular canal dehiscence: illustrative case and systematic review.

作者信息

Lagman Carlito, Ong Vera, Chung Lawrance K, Elhajjmoussa Lekaa, Fong Christina, Wang Anthony C, Gopen Quinton, Yang Isaac

机构信息

Departments of 1 Neurosurgery.

Pediatrics.

出版信息

J Neurosurg Pediatr. 2017 Aug;20(2):196-203. doi: 10.3171/2017.3.PEDS1734. Epub 2017 May 26.

Abstract

OBJECTIVE The purpose of this study is to present an illustrative case of pediatric superior semicircular canal dehiscence (SSCD) and to systematically review the current published literature in the pediatric population. METHODS An electronic search of the Scopus, Web of Science, PsycINFO, Cochrane, and Embase databases was performed by 2 independent authors through January 2017. Search term combinations included "pediatrics," "children," "canal," and "dehiscence." Inclusion criteria were as follows: English, full-text clinical studies, case reports, and case series describing pediatric patient(s) (younger than 18 years) with CT evidence of SSCD. Baseline patient demographic characteristics, clinical presentations, dehiscence characteristics, management strategies, and outcome data were extracted. RESULTS A total of 14 studies involving 122 patients were included in the quantitative synthesis. The patients' mean age was 7.22 years. Male predominance was observed (approximate male-to-female ratio of 1.65:1). Neurodevelopmental disorders were common (n = 14, 11.5%). Auditory signs and symptoms were more common than vestibular signs and symptoms. Hearing loss (n = 62, 50.8%) was the most common auditory symptom and an indicator for imaging evaluation. Vertigo was the most common vestibular symptom (n = 8, 6.6%). Hearing aids were recommended in 8 cases (6.6%), and surgical repair was performed in 1 case (0.8%). Symptom outcomes and follow-up durations were infrequently reported. CONCLUSIONS The authors' data suggest that in pediatric SSCD, males are more commonly affected than females. This is different than the adult population in which females are predominantly affected. A history of otologic and/or neurodevelopmental abnormalities was common. There was a preponderance of auditory symptoms in this age group. Conservative management was favored in the majority.

摘要

目的 本研究旨在呈现一例小儿上半规管裂(SSCD)的说明性病例,并系统回顾目前已发表的有关小儿人群的文献。方法 两名独立作者在2017年1月前对Scopus、科学网、PsycINFO、Cochrane和Embase数据库进行了电子检索。检索词组合包括“儿科”“儿童”“半规管”和“裂开”。纳入标准如下:英文全文临床研究、病例报告和病例系列,描述有SSCD CT证据的小儿患者(18岁以下)。提取患者的基线人口统计学特征、临床表现、裂的特征、治疗策略和结局数据。结果 定量综合分析共纳入14项研究,涉及122例患者。患者的平均年龄为7.22岁。观察到男性占优势(男女比例约为1.65:1)。神经发育障碍很常见(n = 14,11.5%)。听觉症状和体征比前庭症状和体征更常见。听力损失(n = 62,50.8%)是最常见的听觉症状,也是影像学评估的指标。眩晕是最常见的前庭症状(n = 8,6.6%)。8例(6.6%)建议使用助听器,1例(0.8%)进行了手术修复。症状结局和随访时间很少报告。结论 作者的数据表明,在小儿SSCD中,男性比女性更易受影响。这与主要为女性受影响的成人人群不同。耳科和/或神经发育异常病史很常见。该年龄组听觉症状占优势。大多数情况下倾向于保守治疗。

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