Johanis Michael, Yang Isaac, Gopen Quinton
Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, CA, United States; Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, United States.
J Clin Neurosci. 2018 Aug;54:109-112. doi: 10.1016/j.jocn.2018.06.023. Epub 2018 Jun 13.
Superior semicircular canal dehiscence is a rare inner ear disorder characterized by an abnormal third opening between the superior semicircular canal and middle fossa. Symptoms include amplification of internal sounds, aural fullness, tinnitus, hearing loss, autophony, sound-induced vertigo (Tullio phenomenon), pressure-induced vertigo (Hennebert sign), disequilibrium, nystagmus, oscillopsia, and headache. While no cure exists for SSCD, surgical treatment has proven to effectively minimize these symptoms. This study reviewed brainstem auditory evoked potentials (BAEPs) that were monitored intraoperatively to better understand hearing loss risks associated with surgical treatment for SSCD.
A retrospective chart review was conducted at the University of California, Los Angeles on adult patients with a confirmed diagnosis of SSCD who had undergone a middle cranial fossa repair from March 2011 to October 2017. A total of 142 cases of SSCD in 118 patients were repaired.
The majority of patients' BAEPs remained stable and had no intraoperative hearing changes (n = 135; 95.1%). Seven patients experienced intraoperative changes as determined by a prolongation and reduction of Wave V latency (4.9%). Of these seven cases, five experienced a return to baseline prior to the end of surgery, and had no post-operative changes in hearing (71.4%). Overall, only two of the 142 surgeries (1.4%) resulted in failure to normalize and, as such, these patients experienced permanent changes in hearing.
The results of this retrospective review demonstrate a low risk for hearing loss due to SSCD surgery via the middle fossa craniotomy approach.
上半规管裂是一种罕见的内耳疾病，其特征是上半规管与中颅窝之间出现异常的第三开口。症状包括体内声音放大、耳闷、耳鸣、听力损失、自听增强、声音诱发眩晕（图利奥现象）、压力诱发眩晕（亨内伯特征）、平衡失调、眼球震颤、视振荡和头痛。虽然上半规管裂无法治愈，但手术治疗已被证明能有效减轻这些症状。本研究回顾了术中监测的脑干听觉诱发电位（BAEP），以更好地了解与上半规管裂手术治疗相关的听力损失风险。
在加利福尼亚大学洛杉矶分校对2011年3月至2017年10月期间确诊为上半规管裂并接受中颅窝修复术的成年患者进行了回顾性病历审查。共修复了118例患者的142例上半规管裂病例。
大多数患者的BAEP保持稳定，术中听力无变化（n = 135；95.1%）。7例患者术中出现变化，表现为V波潜伏期延长和波幅降低（4.9%）。在这7例病例中，5例在手术结束前恢复至基线水平，术后听力无变化（71.4%）。总体而言，142例手术中只有2例（1.4%）未能恢复正常，因此这些患者的听力出现了永久性变化。
这项回顾性研究的结果表明，通过中颅窝开颅手术治疗上半规管裂导致听力损失的风险较低。
