Department of Neurosurgery, University of California-Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Department of Neurosurgery, University of California-Los Angeles, Los Angeles, California, USA.
World Neurosurg. 2022 Oct;166:e52-e59. doi: 10.1016/j.wneu.2022.06.090. Epub 2022 Jun 26.
Superior semicircular canal dehiscence (SSCD) is caused by bony defects in the osseous shell of the arcuate eminence separating the labyrinth and the intracranial space. This pathologic third window causes hydroacoustic transmission resulting in debilitating symptoms. We examine the pathophysiologic association between metabolic markers, previous medical history, and SSCD symptoms before and after middle fossa craniotomy (MFC) treatment.
This study was conducted between March 2011 and September 2020 with patients with SSCD who underwent MFC. We used a Fisher test to compare variables, including bilateral SSCD, second surgery, ear anomaly, osteoporosis, arthritis, vitamin D, and preoperative/postoperative symptoms, and others. Point-biserial correlation analysis was performed to test correlations between continuous variables and categorical variables.
A total of 250 patients with SSCD underwent MFC repair. There was significant postoperative resolution in all symptoms (P < 0.0001). Laboratory 25-hydroxyvitamin D values correlated with preoperative aural fullness (r= 0.29; P = 0.03), and preoperative disequilibrium (r= -0.32; P = 0.02). Serum calcium values correlated with preoperative hearing loss (r= 0.16; P = 0.02). Osteoporosis history (n = 16; 6%) was more prevalent in female patients (P = 0.0001), associated with higher levels of preoperative hearing loss (odds ratio, 4.56; P = 0.02) and higher postoperative hearing loss resolution (odds ratio, 2.89; P = 0.0509).
Certain metabolic markers may predict SSCD presentation before and after surgery. Previous history of osteoporosis, autoimmune conditions, or arthritis may play a role in SSCD pathophysiology and can help predict clinical outcomes. Future evaluation should take metabolic laboratory values and acquire an exact medical history.
上半规管裂（SSCD）是由连接迷路和颅腔的弓状隆起骨壳中的骨缺陷引起的。这种病理性的第三窗口导致水声学传输，导致衰弱的症状。我们研究了代谢标志物、既往病史与 SSCD 症状之间的病理生理关联，以及 SSCD 患者在接受中颅窝颅底切开术（MFC）治疗前后的情况。
本研究于 2011 年 3 月至 2020 年 9 月期间进行，对象为接受 MFC 治疗的 SSCD 患者。我们使用 Fisher 检验比较了双侧 SSCD、二次手术、耳部异常、骨质疏松症、关节炎、维生素 D 和术前/术后症状等变量。点双变量相关分析用于测试连续变量和分类变量之间的相关性。
共有 250 例 SSCD 患者接受了 MFC 修复。所有症状均有显著的术后缓解（P < 0.0001）。实验室 25-羟维生素 D 值与术前耳部饱满感呈正相关（r= 0.29；P= 0.03），与术前失衡呈负相关（r= -0.32；P= 0.02）。血清钙值与术前听力损失呈正相关（r= 0.16；P= 0.02）。骨质疏松症病史（n= 16；6%）在女性患者中更为常见（P= 0.0001），与术前听力损失程度较高（比值比，4.56；P= 0.02）和术后听力损失缓解程度较高（比值比，2.89；P= 0.0509）相关。
某些代谢标志物可能预测 SSCD 患者术前和术后的表现。既往骨质疏松症、自身免疫性疾病或关节炎病史可能在 SSCD 病理生理学中起作用，并有助于预测临床结局。未来的评估应考虑代谢实验室值并获取详细的病史。
Zotero 插件