Michigan Ear Institute, Farmington Hills, Michigan.
Houston Methodist Hospital, Houston, Texas.
Otol Neurotol. 2021 Jul 1;42(6):806-814. doi: 10.1097/MAO.0000000000003100.
To analyze audiometric data after surgical manipulation of the membranous labyrinth during plugging of superior semicircular canal dehiscence (SSCD) or posterior semicircular canal occlusion (PSCO) for benign paroxysmal positional vertigo.
Retrospective chart review.
Tertiary referral center.
Patients undergoing plugging of SSCD or PSCO between 2009 and 2019.
Pre- and postoperative audiometric data were collected per AAO-HNS guidelines. Hearing outcomes at initial and last follow-up were compared. Subanalyses were performed for surgical approach and age.
Eighty-seven total procedures in 76 patients including 43 middle cranial fossa for SSCD, 29 transmastoid SSCD, and 15 PSCO. Mean preoperative air-conduction-pure-tone averages was 21.1±14.9 dB compared with 26.1 ± 19.6 dB at initial follow-up and 24.4 ± 18.6 dB at last follow-up (p = 0.006). Mean preoperative bone-conduction-pure-tone average was 14.3 ± 11.9 dB compared with 18.3 ± 15.6 dB at initial follow-up and 18.5 ± 16.9 dB at last follow-up (p < 0.001). There were five cases of hearing loss >20 dB including one case of profound sensorineural hearing loss >55 dB. PSCO resulted in the most hearing loss at initial follow-up but largely resolves with time. Transmastoid approaches for SSCD resulted in more hearing loss compared with middle cranial fossa. Hearing outcomes were generally stable for SSCD approaches but showed improvement over time for PSCO. Age >50 was associated with greater hearing loss of 5.2 ± 11.1 dB compared with 1.3 ± 10.5 dB but did not reach statistical significance (p = 0.110).
Surgical manipulation of the membranous labyrinth results in statistically significant hearing loss in a pooled analysis. Transient hearing loss is observed in PSCO and TM SSCD plugging was associated with postoperative hearing loss. There was a trend toward increased hearing loss in patients >50 years old.
分析在治疗良性阵发性位置性眩晕（BPPV）时行上半规管裂（SSCD）或后半规管阻塞（PSCO）填塞术中对膜迷路进行手术操作后的听力数据。
回顾性图表审查。
三级转诊中心。
2009 年至 2019 年间行 SSCD 或 PSCO 填塞术的患者。
根据 AAO-HNS 指南收集术前和术后听力数据。比较初始和末次随访时的听力结果。对手术方法和年龄进行了亚分析。
76 例患者共 87 例次手术，其中 43 例经颅中窝行 SSCD，29 例经乳突行 SSCD，15 例行 PSCO。术前气导纯音平均听阈为 21.1±14.9dB，初始随访时为 26.1±19.6dB，末次随访时为 24.4±18.6dB（p=0.006）。术前骨导纯音平均听阈为 14.3±11.9dB，初始随访时为 18.3±15.6dB，末次随访时为 18.5±16.9dB（p<0.001）。有 5 例听力损失>20dB，其中 1 例为>55dB 的重度感音神经性听力损失。PSCO 在初始随访时听力损失最明显，但随时间推移而基本恢复。经乳突入路行 SSCD 较经颅中窝入路听力损失更大。SSCD 入路的听力结果总体稳定，但 PSCO 随时间推移而改善。年龄>50 岁者听力损失为 5.2±11.1dB，显著高于年龄≤50 岁者的 1.3±10.5dB，但差异无统计学意义（p=0.110）。
膜迷路手术操作会导致汇总分析中出现统计学显著的听力损失。PSCO 中观察到短暂性听力损失，TM SSCD 填塞术后与听力损失相关。年龄>50 岁的患者听力损失增加的趋势。
