Carhart Notch—A Prognostic Factor in Surgery for Otosclerosis
Carhart Notch—A Prognostic Factor in Surgery for Otosclerosis
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DOI：
10.1177/0145561319864571
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发表时间：
2019-09
期刊：
影响因子：
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通讯作者：
A. Wiatr;J. Skladzien;P. Stręk;M. Wiatr
中科院分区：
文献类型：
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作者：
A. Wiatr;J. Skladzien;P. Stręk;M. Wiatr
目的：耳硬化症是骨迷路的基础疾病。这种疾病只发生在人的颞骨区域，以进行性听力损失和耳鸣为特征。材料和方法：本研究旨在寻找以下问题的答案：术前音调听力图中Carhart缺口的存在与否是否影响耳硬化症手术的最终结果。结果：分析包括2010至2016年间因耳硬化症而首次手术的140名患者。研究组包括107名年龄在19岁至62岁(平均年龄：40.33岁)的女性和33名年龄在27岁至59岁(平均年龄：38.23岁)的男性。分析显示，在没有切迹的患者中，椎骨切开术的结果在统计学上好于有切迹的患者在相同的手术中的结果。而在椎骨切除的情况下，情况正好相反。结论：(1)术前听力图中出现深度为10~20分贝、频率为2000赫兹的骨传导曲线折射(所谓的Carhart凹陷)是影响手术后关闭人工耳蜗储备和改善骨传导的不良预后因素。(2)无论术前听力图中有无Carhart切迹，在治疗耳硬化症中，椎骨切开术是最有效的方法。
Objective: Otosclerosis is an underlying disease of the bony labyrinth. This disorder, occurring only within the area of a person’s temporal bone, is characterized by a progressive hearing loss and tinnitus. Material and Methods: The study looked for the answer to the question of whether the presence or absence of Carhart notch in the presurgical tonal audiogram affects the final outcome of the otosclerosis surgery. Results: The analysis included 140 patients operated on for the first time due to otosclerosis between 2010 and 2016. The study group consisted of 107 women aged from 19 to 62 (average age: 40.33) and 33 men aged 27 to 59 (average age: 38.23). Analysis showed a statistically better result of stapedotomy in patients without the notch than in the same procedure in patients with the notch present. The opposite situation occurred in the case of stapedectomy. Conclusion: (1) The presence of a refraction of the bone conduction curve with a depth of 10 to 20 dB at a frequency of 2000 Hz (the so-called Carhart notch) in the presurgical tonal audiogram is an unfavorable prognostic factor in relation to closing the cochlear reserve and improving bone conduction after the stapedotomy. (2) Regardless of the presence or absence of Carhart notch in the presurgical tonal audiogram, stapedotomy is the procedure with the highest efficiency in the treatment of otosclerosis.