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中颅窝底结构中骨的变薄或裂开,在上半规管裂。

Thinning or dehiscence of bone in structures of the middle cranial fossa floor in superior semicircular canal dehiscence.

机构信息

Departments of Head and Neck Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.

Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.

出版信息

J Clin Neurosci. 2020 Apr;74:104-108. doi: 10.1016/j.jocn.2020.01.082. Epub 2020 Feb 7.

Abstract

BACKGROUND

Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder; currently, it is unknown whether the etiopathology underlying this structural irregularity affects neighboring structures. The goal is to investigate the prevalence of bone thinning in areas of the middle cranial fossa (MCF) floor in SSCD and non-SSCD patients.

METHODS

This retrospective study analyzed 100 patients from March 2011 to June 2017 at a tertiary referral center. 100 patients undergoing 118 SSCD repair surgeries (18 bilateral) were identified. 12 SSCD ears were excluded due to lack of pre-operative computed tomography (CT) scans or history of prior SSCD repair at an outside facility. Non-SSCD ears were identified from routinely-obtained CT scans for temporal bone fracture (fractured sides excluded) for a total of 101 ears; 26 non-SSCD ears were excluded due to lack of high-resolution imaging.

RESULTS

Univariate analyses reveal that SSCD diagnosis is associated with higher rates of geniculate ganglion (GG) dehiscence compared with non-SSCD controls (42.7 vs. 24%; χ(1) = 9.69,P = 0.008). Individuals with SSCD depicted significantly thinner bone overlying the geniculate ganglion (GG) (0.23 ± 1.2 mm) compared to controls (0.28 ± 1.8 mm, (t(1 6 4)) = 2.1, P = 0.04). SSCD patients presented thinner bone overlying the internal auditory canal (IAC) (0.33 ± 1.3 mm) compared to patients without SSCD (0.46 ± 1.6 mm, (t(2 5 7) = 6.4, P < 0.001).

CONCLUSIONS

The increased prevalence of dehiscence of the MCF in this cohort of SSCD patients compared to non-SSCD patients suggests that the etiology underlying SSCD affects surrounding structures.

摘要

背景

上半规管裂(SSCD)是一种罕见的内耳疾病;目前尚不清楚导致这种结构异常的病因是否会影响邻近结构。本研究旨在探讨 SSCD 及非 SSCD 患者中中颅窝(MCF)底骨变薄的发生率。

方法

这是一项回顾性研究,分析了 2011 年 3 月至 2017 年 6 月在一家三级转诊中心的 100 例患者。共发现 100 例患者接受了 118 例 SSCD 修复手术(18 例双侧)。由于缺乏术前计算机断层扫描(CT)或既往在外部机构进行 SSCD 修复的病史,12 例 SSCD 耳被排除在外。共从常规获得的颞骨骨折 CT 扫描中确定了 101 例非 SSCD 耳(骨折侧除外);由于缺乏高分辨率成像,26 例非 SSCD 耳被排除在外。

结果

单变量分析显示,与非 SSCD 对照组相比,SSCD 诊断与更高的膝状神经节(GG)裂发生率相关(42.7%比 24%;χ(1) = 9.69,P = 0.008)。SSCD 组 GG 上方的骨明显更薄(0.23 ± 1.2mm),而对照组为 0.28 ± 1.8mm(t(164) = 2.1,P = 0.04)。SSCD 患者 IAC 上方的骨更薄(0.33 ± 1.3mm),而非 SSCD 患者为 0.46 ± 1.6mm(t(257) = 6.4,P < 0.001)。

结论

与非 SSCD 患者相比,本 SSCD 患者队列中 MCF 裂的发生率增加,表明 SSCD 的病因会影响周围结构。

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