Charusripan Paninee, Chinachatchawarat Methit, Rojvachiranonda Nond
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, 1873 Rama IV Rd. Pathumwan, Bangkok, Thailand.
Excellent Center in Otolaryngology Head and Neck Surgery, Rajavithi, Bangkok, Thailand.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2333-2339. doi: 10.1007/s00405-024-09129-3. Epub 2024 Dec 23.
This study analyzes temporal bone thickness in pediatric craniofacial anomalies patients to determine the optimal age for preoperative high-resolution computed tomography (HRCT) and enhance surgical planning of bone conduction hearing implants.
A retrospective examination of 370 temporal bone HRCT scans from 158 pediatric patients with craniofacial anomalies was conducted. Statistical analysis included descriptive statistics and correlation between age and skull thickness.
The study revealed a correlation between age and skull thickness, emphasizing the importance of preoperative HRCT at 5 years or older for a comprehensive evaluation. The bone thickness on the ipsilateral side of the disease was not significantly different from the non-disease side (p-value 0.41; 95% CI: - 0.28, 0.68). Thickness increased significantly in the first two years but displayed variability in older age groups, particularly in patients with syndromic craniosynostosis. Exclusion of untreated patients led to a more coherent correlation between thickness and age.
Bone conduction hearing implants are feasible in children under 5 years, but for those aged five or older with craniofacial anomalies, preoperative temporal bone HRCT is crucial for comprehensive evaluation. Relying solely on age for implantation timing is insufficient, emphasizing the need for individualized assessment and caution in syndromic cases.
本研究分析小儿颅面畸形患者的颞骨厚度，以确定术前高分辨率计算机断层扫描（HRCT）的最佳年龄，并加强骨传导听力植入物的手术规划。
对158例小儿颅面畸形患者的370份颞骨HRCT扫描进行回顾性检查。统计分析包括描述性统计以及年龄与颅骨厚度之间的相关性。
研究揭示了年龄与颅骨厚度之间的相关性，强调5岁及以上患者进行术前HRCT以进行全面评估的重要性。病变同侧的骨厚度与非病变侧无显著差异（p值0.41；95%置信区间：-0.28，0.68）。厚度在头两年显著增加，但在年龄较大的组中存在变异性，特别是综合征性颅缝早闭患者。排除未治疗的患者后，厚度与年龄之间的相关性更一致。
骨传导听力植入物在5岁以下儿童中是可行的，但对于5岁及以上的颅面畸形患者，术前颞骨HRCT对于全面评估至关重要。仅依靠年龄来确定植入时机是不够的，强调在综合征病例中需要进行个体化评估并谨慎行事。
