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.
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.
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。
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