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特发性颅内高压患者中的半规管裂

Semicircular canal dehiscence among idiopathic intracranial hypertension patients.

作者信息

Kuo Phoebe, Bagwell Kenneth A, Mongelluzzo Gino, Schutt Christopher A, Malhotra Ajay, Khokhar Babar, Kveton John F

机构信息

Department of Surgery-Otolaryngology, Yale School of Medicine, New Haven, Connecticut, U.S.A.

Department of Radiology, Geisinger Medical Center, Danville, Pennsylvania, U.S.A.

出版信息

Laryngoscope. 2018 May;128(5):1196-1199. doi: 10.1002/lary.26795. Epub 2017 Aug 22.

Abstract

OBJECTIVES/HYPOTHESIS: The cause of superior semicircular canal dehiscence (SSCD) is unknown. Because of a demonstrated association with tegmental defects and obesity, some have suggested idiopathic intracranial hypertension (IIH) could contribute by eroding the bone over the canal and resulting in SSCD. However, an association between IIH and SSCD has not previously been evaluated. Our objective was to evaluate an association between IIH and SSCD.

STUDY DESIGN

Retrospective cohort.

METHODS

A retrospective study was performed of opening pressures for consecutive patients presenting at a lumbar puncture clinic between August 2012 and October 2015. Imaging for patients who also had thin-sectioned computed tomography (CT) imaging was reviewed for the presence of radiographic SSCD. Association between IIH and SSCD was evaluated using the Student t test and multivariate logistic regression.

RESULTS

One hundred twenty-one patients had both a lumbar puncture performed and thin-sectioned CT imaging available, of which 24 patients (19.8%) met the criteria for IIH with an opening pressure >25 cm H O. The remaining 97 patients (80.2%) did not have elevated opening pressures and served as the control cohort. None of the 24 patients with IIH had radiographic SSCD, whereas eight of the 97 patients (8.2%) without IIH had radiographic SSCD. The average opening pressure in patients without radiographic SSCD was 20.2 cm H O compared to 19.3 cm H O in patients with radiographic SSCD (P = .521). In multivariate logistic regression controlling for age, body mass index, gender, and comorbidities (hypertension, diabetes, hyperlipidemia), opening pressure was not a significant predictor of radiographic SSCD.

CONCLUSIONS

The results of this retrospective pilot study do not suggest an association between IIH and SSCD.

LEVEL OF EVIDENCE

3b. Laryngoscope, 128:1196-1199, 2018.

摘要

目的/假设:上半规管裂(SSCD)的病因尚不清楚。由于已证实其与脑桥被盖部缺损及肥胖有关,一些人认为特发性颅内高压(IIH)可能通过侵蚀半规管上方的骨质并导致SSCD。然而,此前尚未评估过IIH与SSCD之间的关联。我们的目的是评估IIH与SSCD之间的关联。

研究设计

回顾性队列研究。

方法

对2012年8月至2015年10月在腰椎穿刺门诊连续就诊患者的初压进行回顾性研究。对同时进行了薄层计算机断层扫描(CT)成像的患者影像进行检查,以确定是否存在影像学上的SSCD。使用学生t检验和多因素逻辑回归评估IIH与SSCD之间的关联。

结果

121例患者既进行了腰椎穿刺又有薄层CT成像资料,其中24例患者(19.8%)符合IIH标准,初压>25 cm H₂O。其余97例患者(80.2%)初压未升高,作为对照队列。24例IIH患者中无一例有影像学上的SSCD,而97例无IIH的患者中有8例(8.2%)有影像学上的SSCD。无影像学SSCD患者的平均初压为20.2 cm H₂O,有影像学SSCD患者的平均初压为19.3 cm H₂O(P = 0.521)。在控制年龄、体重指数、性别和合并症(高血压、糖尿病、高脂血症)的多因素逻辑回归分析中,初压不是影像学SSCD的显著预测因素。

结论

这项回顾性初步研究的结果未提示IIH与SSCD之间存在关联。

证据级别

3b。《喉镜》,2018年,第128卷,第1196 - 1199页。

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