Measuring growth of residual cholesteatoma in subtotal petrosectomy
Measuring growth of residual cholesteatoma in subtotal petrosectomy
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DOI：
10.1080/00016489.2019.1578413
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发表时间：
2019-03-04
影响因子：
1.4
通讯作者：
van Spronsen, Erik
中科院分区：
文献类型：
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作者：
Hellingman, Catharine A.;Logher, Joris L. E.;van Spronsen, Erik
背景：对胆脂瘤患者的生长速度知之甚少。目的：根据MRI扫描测量的体积，研究岩层次全切除术中残留胆脂瘤的生长情况。材料和方法：对某三级医疗中心的病例进行回顾性分析。在10名患者中发现了13个残留的胆脂瘤，在岩石次全切除后，采取了等待和扫描的策略。残余胆脂瘤的体积通过手工分割和‘盒方法’来计算。结果：平均生长速度为27.9mm~3/月(SD 22.8)，个体差异较大，为2.2~69.8mm~3/月。有10名患者在岩石次全切除术中对残留胆脂瘤采取等待和扫描策略，没有并发症的报道。与参考方法人工分割相比，BOX方法高估了生长率，并且随着胆脂瘤大小的增加，这种系统误差呈线性增加。结论：残留胆脂瘤的生长速度有很大的个体差异。可以考虑采取等待和扫描的政策，以防在破坏任何剩余结构之前有足够的生长空间的岩石次全切除(少量)残留物。此外，临床上更适用、耗时更少的盒法可用于精确测量小胆脂瘤的体积，最大可达500 mm(3)。
Background: Little is known about the growth rate of cholesteatoma in patients. Objective: Investigate the growth of residual cholesteatoma in subtotal petrosectomy based on volume measured in MRI scans. Materials and methods: Retrospective case series in a Tertiary Medical Centre. Thirteen residual cholesteatomas were identified in 10 patients after subtotal petrosectomy for which a wait-and-scan policy was adopted. Volume of the residual cholesteatoma was calculated by manual segmentation as well as the 'box method'. Results: Mean growth rate was 27.9 mm3/month (SD 22.8), with a large individual variation ranging from 2.2 to 69.8 mm3/month. No complications were reported in 10 patients with a wait-and-scan policy for residual cholesteatoma in subtotal petrosectomy. The box method overestimates growth rate compared to the reference method manual segmentation and a linear increase of this systematic error was seen with increasing size of the cholesteatoma. Conclusions: Residual cholesteatoma growth rate shows a large individual variation. A wait-and-scan policy could be considered in case of a (small) residual in subtotal petrosectomy with ample room to grow before destroying any remaining structures. Furthermore, the clinically more applicable and less time-consuming box method can be used to accurately measure volumes of small cholesteatomasup to a volume of 500 mm(3).