Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2012
Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Ward Bryan K, Agrawal Yuri, Nguyen Elena, Della Santina Charles C, Limb Charles J, Francis Howard W, Minor Lloyd B, Carey John P
Аннотация
OBJECTIVE: To determine postoperative hearing outcomes after surgical plugging via middle cranial fossa approach for superior semicircular canal dehiscence syndrome (SCDS).
STUDY DESIGN: Clinical review.
SETTING: Tertiary care medical center.
PATIENTS: Forty-three cases of SCDS based on history, physical examination, vestibular function testing, and computed tomography imaging confirming the presence of a dehiscence. All patients underwent surgical plugging of the superior semicircular canal via middle cranial fossa approach.
INTERVENTION: Pure tone audiometry was performed preoperatively and at 7 days and at least 1 month postoperatively.
MAIN OUTCOME MEASURES: Change in air-bone gap (ABG) and pure tone average (PTA).
RESULTS: Preoperative average ABG across 0.25, 0.5, 1, and 2 kHz was 16.0 dB (standard deviation [SD], 7.5 dB). At 7 days postoperatively, average ABG was 16.5 dB (SD, 11.1; p = 0.42), and at greater than 1 month was 8.1 dB (SD, 8.4; p < 0.001). 53% (95% confidence interval, 33-69) of affected ears had greater than 10 dB increase in their 4-frequency (0.5, 1, 2, and 4 kHz) PTA measured by bone-conduction (BC) threshold 7 days postoperatively and 25% (95% confidence interval, 8-39) at greater than 1 month postoperatively. Mean BC PTA of affected ears was 8.4 dB hearing loss (HL) (SD, 10.4) preoperatively. Compared with baseline, this declined to 19.2 dB HL (SD, 12.6; p < 0.001) at 7 days postoperatively and 16.4 dB HL (SD, 18.8; p = 0.01) at greater than 1 month. No significant differences in speech discrimination score were noted (F = 0.17).
CONCLUSION: Low-frequency air-bone gap decreases after surgical plugging and seems to be due to both increased BC thresholds and decreased AC thresholds. Surgical plugging via a middle cranial fossa approach in SCDS is associated with mild high-frequency sensorineural hearing loss that persists in 25% but no change in speech discrimination.
STUDY DESIGN: Clinical review.
SETTING: Tertiary care medical center.
PATIENTS: Forty-three cases of SCDS based on history, physical examination, vestibular function testing, and computed tomography imaging confirming the presence of a dehiscence. All patients underwent surgical plugging of the superior semicircular canal via middle cranial fossa approach.
INTERVENTION: Pure tone audiometry was performed preoperatively and at 7 days and at least 1 month postoperatively.
MAIN OUTCOME MEASURES: Change in air-bone gap (ABG) and pure tone average (PTA).
RESULTS: Preoperative average ABG across 0.25, 0.5, 1, and 2 kHz was 16.0 dB (standard deviation [SD], 7.5 dB). At 7 days postoperatively, average ABG was 16.5 dB (SD, 11.1; p = 0.42), and at greater than 1 month was 8.1 dB (SD, 8.4; p < 0.001). 53% (95% confidence interval, 33-69) of affected ears had greater than 10 dB increase in their 4-frequency (0.5, 1, 2, and 4 kHz) PTA measured by bone-conduction (BC) threshold 7 days postoperatively and 25% (95% confidence interval, 8-39) at greater than 1 month postoperatively. Mean BC PTA of affected ears was 8.4 dB hearing loss (HL) (SD, 10.4) preoperatively. Compared with baseline, this declined to 19.2 dB HL (SD, 12.6; p < 0.001) at 7 days postoperatively and 16.4 dB HL (SD, 18.8; p = 0.01) at greater than 1 month. No significant differences in speech discrimination score were noted (F = 0.17).
CONCLUSION: Low-frequency air-bone gap decreases after surgical plugging and seems to be due to both increased BC thresholds and decreased AC thresholds. Surgical plugging via a middle cranial fossa approach in SCDS is associated with mild high-frequency sensorineural hearing loss that persists in 25% but no change in speech discrimination.
Предметные рубрики MeSH
AdultAgedAudiometry, Pure-ToneAuditory ThresholdBone ConductionCranial Fossa, MiddleData Interpretation, StatisticalEar DiseasesFemaleFollow-Up StudiesHearingHearing Loss, SensorineuralHumansMaleMiddle AgedOtologic Surgical ProceduresSemicircular CanalsSpeech PerceptionSurgery, Computer-AssistedSurgical InstrumentsTomography, X-Ray ComputedTreatment OutcomeVestibular Function Tests