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一种用于上半规管裂综合征的循证诊断工具。

An evidenced-based diagnostic tool for superior semicircular canal dehiscence syndrome.

作者信息

Fritz Christian G, Casale Garrett G, Kana Lulia A, Hong Robert S

机构信息

Michigan Ear Institute, Farmington Hills, Michigan, USA.

Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

J Otol. 2023 Oct;18(4):230-234. doi: 10.1016/j.joto.2023.09.006. Epub 2023 Sep 20.

DOI:10.1016/j.joto.2023.09.006
PMID:37877067
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10593562/
Abstract

PURPOSE

To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence (SSCD) on high-resolution CT.

MATERIALS AND METHODS

Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.

RESULTS

A total of 168 patients were included, of which 118 had imaging-confirmed SSCD. On univariate analysis significant predictors of SSCD presence were: sound/pressure-induced vertigo ( = 0.006), disequilibrium ( = 0.008), hyperacusis ( = 0.008), and autophony ( = 0.034). Multivariate analysis enabled a 14-point symptom-weighted tool to be developed, wherein a score of ≥6 raised the suspicion of SSCD (≥70% likelihood of being present), R = 0.853.

CONCLUSIONS

The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation. Using the evidenced-based diagnostic tool validated herein, a score ≥6 with any symptom combination justifies ordering a CT scan.

摘要

目的

构建一种基于症状的预测工具,以评估高分辨率CT上半规管裂(SSCD)的可能性。

材料与方法

在一家三级神经耳科学转诊中心采用数学建模来预测SSCD的影像学证据。

结果

共纳入168例患者,其中118例经影像学证实为SSCD。单因素分析显示,SSCD存在的显著预测因素为:声音/压力诱发的眩晕(P = 0.006)、平衡失调(P = 0.008)、听觉过敏(P = 0.008)和自听过强(P = 0.034)。多因素分析得出了一个14分的症状加权工具,其中评分≥6分则增加对SSCD的怀疑(存在可能性≥70%),R = 0.853。

结论

根据就诊时记录的症状,可高度确定CT扫描上SSCD的可能性。使用本文验证的循证诊断工具,任何症状组合评分≥6分即有理由进行CT扫描。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c4/10593562/042f53b6efef/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c4/10593562/1bb67a774661/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c4/10593562/042f53b6efef/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c4/10593562/1bb67a774661/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c4/10593562/042f53b6efef/gr2.jpg

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Otol Neurotol. 2022 Feb 1;43(2):146-152. doi: 10.1097/MAO.0000000000003430.
2
Superior semicircular canal dehiscence: a narrative review.上半规管裂:综述。
J Laryngol Otol. 2022 Apr;136(4):284-292. doi: 10.1017/S0022215121002826. Epub 2021 Oct 7.
3
A Cohort Study Comparing Importance of Clinical Factors in Determining Diagnosis and Treatment for Superior Semicircular Canal Dehiscence Syndrome.
一项比较临床因素对确定上半规管裂综合征诊断和治疗重要性的队列研究。
Otol Neurotol. 2021 Oct 1;42(9):1429-1433. doi: 10.1097/MAO.0000000000003274.
4
Hearing Outcomes After Surgical Manipulation of the Membranous Labyrinth During Superior Semicircular Canal Dehiscence Plugging or Posterior Semicircular Canal Occlusion.膜迷路手术处理在上半规管裂孔填塞或后半规管阻塞术中的听力结果。
Otol Neurotol. 2021 Jul 1;42(6):806-814. doi: 10.1097/MAO.0000000000003100.
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Bone-conduction hyperacusis induced by superior canal dehiscence in human: the underlying mechanism.人类上半规管裂引起的骨导听觉过敏:潜在机制。
Sci Rep. 2020 Oct 6;10(1):16564. doi: 10.1038/s41598-020-73565-4.
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Validating the Utility of High Frequency Ocular Vestibular Evoked Myogenic Potential Testing in the Diagnosis of Superior Semicircular Canal Dehiscence.验证高频眼震前庭诱发肌源性电位测试在诊断上半规管裂中的效用。
Otol Neurotol. 2019 Dec;40(10):1353-1358. doi: 10.1097/MAO.0000000000002388.
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AJNR Am J Neuroradiol. 2019 Apr;40(4):709-712. doi: 10.3174/ajnr.A5999. Epub 2019 Feb 28.
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Aggregating the symptoms of superior semicircular canal dehiscence syndrome.汇总上半规管裂综合征的症状。
Laryngoscope. 2018 Aug;128(8):1932-1938. doi: 10.1002/lary.27062. Epub 2017 Dec 27.
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