Nguyen Thien, Lagman Carlito, Sheppard John P, Duong Courtney, Ong Vera, Poon Jessica, Alkhalid Yasmine, Azzam Daniel, Romiyo Prasanth, Prashant Giyarpuram N, Gopen Quinton, Yang Isaac
Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA.
Department of Head and Neck Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA.
World Neurosurg. 2018 Jun;114:e42-e50. doi: 10.1016/j.wneu.2018.02.017. Epub 2018 Feb 13.
Superior semicircular canal dehiscence (SSCD) is a bony defect in the osseous shell of the petrous temporal bone. The pathophysiological association between osteoporosis and SSCD remains poorly understood. We investigated the relationship between bone metabolic markers and symptoms in patients with SSCD.
We collected patient demographics and clinical parameters for adult patients diagnosed with SSCD on high-resolution computed tomography scans. We used point-biserial correlation analysis to investigate the relationship between bone metabolic markers and symptoms in patients with SSCD. We compared clinical symptoms before and after surgical repair of SSCD through a middle fossa craniotomy using McNemar's test for paired comparisons of binary measures.
We included a total of 99 patients (64 females and 35 males; average age 52 years; 118 surgeries). The level of serum calcium correlated with the need for a second surgery (r = -0.35, P = 0.001). Postoperative calcium supplementation negatively correlated with improvement in dizziness (r = -0.36, P = 0.01). The level of 25-hydroxyvitamin D correlated with preoperative hyperacusis (r = -0.98, P = 0.02) and postoperative autophony (r = 0.96, P = 0.04). Postoperative vitamin D supplementation positively correlated with hearing decline (r = 0.04, P = 0.04) The level of thyroid stimulating hormone correlated with preoperative autophony, amplification, and tinnitus (r = -0.71, r = -0.75, r = -0.70, all P < 0.001).
Bone metabolic markers could be important in the clinical assessment of SSCD patients and could be potential targets for symptom management.
上半规管裂（SSCD）是颞骨岩部骨壳的一种骨质缺损。骨质疏松与SSCD之间的病理生理关联仍知之甚少。我们研究了SSCD患者骨代谢标志物与症状之间的关系。
我们收集了经高分辨率计算机断层扫描诊断为SSCD的成年患者的人口统计学和临床参数。我们使用点二列相关分析来研究SSCD患者骨代谢标志物与症状之间的关系。我们通过中颅窝开颅手术对SSCD进行手术修复前后的临床症状进行比较，采用McNemar检验进行二元测量的配对比较。
我们共纳入99例患者（64例女性和35例男性；平均年龄52岁；118例手术）。血清钙水平与二次手术需求相关（r = -0.35，P = 0.001）。术后补钙与头晕改善呈负相关（r = -0.36，P = 0.01）。25-羟维生素D水平与术前听觉过敏相关（r = -0.98，P = 0.02）和术后自听过强相关（r = 0.96，P = 0.04）。术后补充维生素D与听力下降呈正相关（r = 0.04，P = 0.04）促甲状腺激素水平与术前自听过强、重振和耳鸣相关（r = -0.71，r = -0.75，r = -0.70，均P < 0.001）。
骨代谢标志物在SSCD患者的临床评估中可能很重要，并且可能是症状管理的潜在靶点。
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