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上半规管裂综合征手术后患者的长期报告结局

Long-Term Patient-Reported Outcomes After Surgery for Superior Canal Dehiscence Syndrome.

作者信息

Alkhafaji Mohammed S, Varma Sanskriti, Pross Seth E, Sharon Jeffrey D, Nellis Jason C, Santina Charles C Della, Minor Lloyd B, Carey John P

机构信息

*Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland †Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco ‡Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California.

出版信息

Otol Neurotol. 2017 Oct;38(9):1319-1326. doi: 10.1097/MAO.0000000000001550.

DOI:10.1097/MAO.0000000000001550
PMID:28902804
Abstract

OBJECTIVE

Evaluate the long-term patient-reported outcomes of surgery for superior canal dehiscence syndrome (SCDS).

STUDY DESIGN

Cross-sectional survey.

SETTING

Tertiary referral center.

PATIENTS

Adults who have undergone surgery for SCDS with at least 1 year since surgery.

MAIN OUTCOME MEASURE(S): Primary outcome: change in symptoms that led to surgery.

SECONDARY OUTCOMES

change in 11 SCDS-associated symptoms, change in psychosocial metrics, and willingness to recommend surgery to friends with SCDS.

RESULTS

Ninety-three (43%) respondents completed the survey with mean (SD) time since surgery of 5.3 (3.6) years. Ninety-five percent of respondents reported the symptoms that led them to have surgery were "somewhat better," "much better," or "completely cured." Those with unilateral symptoms were more likely to report improvement than those with bilateral symptoms. There was no difference between those with short (1-5 yr) versus long (5-20 yr) follow-up. Each of the SCDS-associated symptoms showed significant improvement. The largest improvements were for autophony, pulsatile tinnitus, audible bodily sounds, and sensitivity to loud sound. Headaches, imbalance, dizziness, and brain fog showed the least improvements. Most patients reported improvements in quality of life, mood, and ability to function at work and socially. Ninety-five percent of patients would recommend SCDS surgery.

CONCLUSIONS

Respondents demonstrated durable improvements in the symptoms that led them to have surgery. Auditory symptoms had the greatest improvements. Headaches, imbalance, dizziness, and brain fog showed the least improvements. Nearly, all patients would recommend SCDS surgery to others. These results can be used to counsel patients regarding the lasting benefits of surgery for SCDS.

摘要

目的

评估上半规管裂综合征(SCDS)手术的长期患者报告结局。

研究设计

横断面调查。

研究地点

三级转诊中心。

患者

接受SCDS手术且术后至少1年的成年人。

主要结局指标

主要结局:导致手术的症状变化。

次要结局

11种与SCDS相关症状的变化、心理社会指标的变化以及向患有SCDS的朋友推荐手术的意愿。

结果

93名(43%)受访者完成了调查,自手术以来的平均(标准差)时间为5.3(3.6)年。95%的受访者表示导致他们接受手术的症状“有所改善”、“大有改善”或“完全治愈”。单侧症状的患者比双侧症状的患者更有可能报告症状改善。随访时间短(1 - 5年)与长(5 - 20年)的患者之间没有差异。每种与SCDS相关的症状均显示出显著改善。改善最大的是耳内自听增强、搏动性耳鸣、可闻及的身体声音以及对大声的敏感性。头痛、平衡失调、头晕和脑雾的改善最少。大多数患者报告生活质量、情绪以及工作和社交功能方面有所改善。95%的患者会推荐SCDS手术。

结论

受访者在导致他们接受手术的症状方面表现出持久改善。听觉症状改善最大。头痛、平衡失调、头晕和脑雾的改善最少。几乎所有患者都会向他人推荐SCDS手术。这些结果可用于向患者提供有关SCDS手术持久益处的咨询。

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