Succar Eric F, Manickam Periakaruppan V, Wing Sara, Walter Jeffrey, Greene Joseph S, Azeredo William J
Department of Otolaryngology , Geisinger Medical Center, Danville, Pennsylvania, U.S.A.
Commonwealth Medical College, Scranton, Pennsylvania, U.S.A.
Laryngoscope. 2018 Jun;128(6):1445-1452. doi: 10.1002/lary.26899. Epub 2017 Oct 9.
OBJECTIVES/HYPOTHESIS: Objectives were to describe the use of round window plugging for superior semicircular canal dehiscence syndrome and review further recommendations regarding the procedure based on our experience and to compare results with recent literature on round window plugging.
Retrospective case series.
Fourteen patients underwent round window plugging for superior semicircular canal dehiscence at our institution from 2012 to 2015. All patients underwent the same surgical procedure. Available pre- and postoperative data were reviewed.
Fourteen patient charts were reviewed. Symptoms of autophony improved in nine of 14 (64%) patients. Symptoms of pressure-induced vertigo improved in seven of 12 (58%) patients. Hennebert's sign that was positive preoperatively only improved in one of six (17%) patients. A positive preoperative vestibular evoked myogenic potential improved in only one of six (17%) patients. Six of 13 (46%) patients had increased air conduction thresholds postoperatively.
Round window plugging has been described as a less-invasive treatment for patients with superior semicircular canal dehiscence. Although the procedure did benefit some of our patients, successful outcomes were not predictable. Improvement in at least one objective finding was seen in only 21% of the patients studied. Hennebert's sign and vestibular evoked myogenic potentials that were positive preoperatively only improved in 17% of patients. At our institution, round window plugging is no longer considered a reasonable treatment option for most patients with superior semicircular canal dehiscence. We recommend that further study on this topic follow a standardized pre- and postoperative assessment.
目的/假设：目的是描述圆窗堵塞术在治疗上半规管裂综合征中的应用，并根据我们的经验回顾有关该手术的进一步建议，以及将结果与近期关于圆窗堵塞术的文献进行比较。
回顾性病例系列研究。
2012年至2015年期间，我们机构有14例患者因上半规管裂接受了圆窗堵塞术。所有患者均接受相同的手术操作。对现有的术前和术后数据进行了回顾。
回顾了14例患者的病历。14例患者中有9例（64%）的耳内自听症状得到改善。12例患者中有7例（58%）的压力性眩晕症状得到改善。术前阳性的亨内贝格征仅在6例患者中的1例（17%）得到改善。术前阳性的前庭诱发肌源性电位仅在6例患者中的1例（17%）得到改善。13例患者中有6例（46%）术后气导阈值升高。
圆窗堵塞术被描述为一种治疗上半规管裂患者的侵入性较小的方法。尽管该手术确实使部分患者受益，但成功结果无法预测。在仅21%的研究患者中观察到至少一项客观指标有所改善。术前阳性的亨内贝格征和前庭诱发肌源性电位仅在17%的患者中得到改善。在我们机构，对于大多数上半规管裂患者，圆窗堵塞术不再被认为是一种合理的治疗选择。我们建议对此主题的进一步研究应遵循标准化的术前和术后评估。
4。《喉镜》，128:1445 - 1452，2018年。
