Wolfovitz Amit, Grobman Ariel B, Babcock Thomas A, Angeli Simon I
Department of Otolaryngology-Head and Neck Surgery University of Miami, Miller School of Medicine Miami Florida.
Laryngoscope Investig Otolaryngol. 2018 Dec 20;4(1):132-137. doi: 10.1002/lio2.239. eCollection 2019 Feb.
To analyze demographic, clinical, surgical, and audiometric factors that may affect hearing outcome following surgery for the semicircular canals (SCC).
This is a retrospective case review of adults who underwent surgeries for superior SCC (SSCC), lateral SCC (LSCC), or posterior SCC (PSCC) and whose data were extracted and analyzed for factors affecting the hearing outcome in these procedures.
Thirteen patients underwent surgery for SSCC, seven cases for the LSCC, one for the PSCC, and one case of combined PSCC/SSCC surgery. The mean age was 49.8 ± 12 years (21-66). There was no difference between the preoperative and postoperative pure tone average (PTA) thresholds at 0.5-3 kHz. Higher thresholds were noted at 4, 6, and 8 kHz postoperatively. Deterioration (>10 dB) in the bone-conduction (BC) PTA was demonstrated in 3 of 22 (13.6%) cases with no significant difference in the demographic, clinical, surgical, and preoperative audiometric parameters relative to the cases without PTA BC change. A significantly larger difference in PTA BC (pre- vs. postoperative) was seen for males. Small effect size was noted for Air conduction (AC) PTA in males, and moderate effect size for Word Recognition Score (WRS) in surgery for the LSCC compare to SSCC.
SCC surgeries carry a relatively low risk of deterioration in PTA BC. High frequency thresholds should also be included in postoperative hearing outcome assessment. Cases of LSCC for intractable Meniere's disease and surgery in males carry higher risk of poor postoperative hearing outcomes. 4.
分析可能影响半规管(SCC)手术后听力结果的人口统计学、临床、手术和听力测定因素。
这是一项对接受上半规管(SSCC)、外半规管(LSCC)或后半规管(PSCC)手术的成年人进行的回顾性病例分析,提取并分析了这些手术中影响听力结果的因素。
13例患者接受了SSCC手术,7例接受了LSCC手术,1例接受了PSCC手术,1例接受了PSCC/SSCC联合手术。平均年龄为49.8±12岁(21 - 66岁)。0.5 - 3kHz的术前和术后纯音平均(PTA)阈值无差异。术后4、6和8kHz处的阈值较高。22例中有3例(13.6%)骨导(BC)PTA恶化(>10dB),与BC PTA无变化的病例相比,其人口统计学、临床、手术和术前听力测定参数无显著差异。男性的BC PTA(术前与术后)差异显著更大。男性气导(AC)PTA的效应量较小,与SSCC相比,LSCC手术中单词识别分数(WRS)的效应量为中等。
SCC手术导致BC PTA恶化的风险相对较低。术后听力结果评估中也应包括高频阈值。难治性梅尼埃病的LSCC病例和男性手术的术后听力结果较差的风险较高。 4.