A Superior Semicircular Canal Dehiscence Syndrome Multicenter Study: Is There an Association Between Size and Symptoms?
A Superior Semicircular Canal Dehiscence Syndrome Multicenter Study: Is There an Association Between Size and Symptoms?
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DOI：
10.1097/mao.0b013e3181d27740
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发表时间：
2010-04-01
影响因子：
2.1
通讯作者：
Linder, Thomas
中科院分区：
文献类型：
--
作者：
Pfammatter, Alain;Darrouzet, Vincent;Linder, Thomas
目的：本次调查的目的是确定上半规管裂开综合征患者的管裂大小与症状和体征之间是否存在关联。研究设计：前瞻性多中心研究。地点：三级转诊中心。患者：27 名患者，其中 14 名女性和 13 名男性，年龄 25 至 83 岁，来自瑞士、法国、比利时或意大利，通过颞骨高分辨率计算机断层扫描诊断上半规管裂开。干预措施：听力测试、一系列前庭测试（Tullio 现象、Hennebert 征、Valsalva 动作）、前庭诱发肌源电位 (VEMP) 和颞骨高分辨率计算机断层扫描。主要结果指标：症状/体征与上半规管大小之间的关联结果：临床上，患者可分为三组：上耳管裂开（>= 2.5 mm）主要表现为耳蜗前庭症状和/或体征（敏感性，91.7%；特异性，70%），而较小的则表现为耳蜗或前庭功能障碍。与骨缺损较小的受试者相比，裂开较大的患者与前庭耳蜗症状/体征、较低的 VEMP 阈值和客观前庭表现（例如，Tullio 现象）的相关性显着更高。未发现裂开大小与听力图模式或个体发现之间存在显着关联。裂口的位置似乎对临床表现和检查结果没有影响。结论：与较小的上半管裂口患者相比，上半管裂口较大的患者表现出明显更多的前庭耳蜗症状/体征、较低的VEMP阈值和客观前庭表现。较小的裂开主要表现为耳蜗或前庭功能障碍。
Objective: The aim of this investigation was to determine if there is any association between the size of the canal dehiscences and the symptoms and signs of patients presenting with the superior semicircular canal dehiscence syndrome.Study Design: Prospective multicenter study.Setting: Tertiary referral center.Patients: Twenty-seven patients, 14 females and 13 males, aged 25 to 83 years, coming from Switzerland, France, Belgium, or Italy, with dehiscence of the superior semicircular canal diagnosed by high-resolution computed tomographic scans of the temporal bone.Interventions: Audiologic tests, a battery of vestibular tests (Tullio phenomenon, Hennebert sign, Valsalva maneuver), vestibular evoked myogenic potentials (VEMPs), and high-resolution computed tomographic scans of the temporal bone.Main Outcome Measures: Association between the symptoms/signs and the size of the superior canal dehiscence.Results: Clinically patients could be divided into three different groups: Superior canal dehiscences (>= 2.5 mm) presented predominantly with cochleovestibular symptoms and/or signs (sensitivity, 91.7%; specificity, 70%), whereas smaller one's showed either cochlear or vestibular dysfunction. Patients with larger dehiscences were significantly more associated with vestibulocochlear symptoms/signs, lower VEMP thresholds, and objective vestibular findings ( e. g., Tullio phenomenon) than subjects with smaller bony defects. No significant association between the size of the dehiscence and the audiogram pattern or individual findings could be found. The location of the dehiscence seemed to have no influence on the clinical manifestation and findings.Conclusion: Patients with larger superior canal dehiscences show significantly more vestibulocochlear symptoms/signs, lower VEMP thresholds, and objective vestibular findings compared with smaller ones. Smaller dehiscences mainly present with either cochlear or vestibular dysfunction.