Cholesteatoma Is Associated With Pediatric Progressive Sensorineural Hearing Loss.
Cholesteatoma Is Associated With Pediatric Progressive Sensorineural Hearing Loss.
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胆脂瘤与儿童进行性感音神经性听力损失有关。
DOI：
10.1097/aud.0000000000001176
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发表时间：
2022-07-01
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
本研究利用大型儿童纵向听力学数据集确定了胆脂瘤与进行性感音神经性听力损失之间的关系。胆脂瘤是积液性慢性中耳炎的潜在后遗症，这是一种常见的听觉病理，可导致儿童听力损失。本报告的目的是(i)描述在一个大型儿科数据集中确定胆脂瘤与进行性感音神经性听力损失之间关系的过程，（ii）描述在确定为胆脂瘤相关的进行性感音神经性听力损失的患者中随时间获得的听力学数据。纳入听力学和遗传学数据库的患者记录（n=175,215例患者）使用定义进行性听力损失的特定标准进行检查。线性回归模型检查了电子健康记录中分配给进行性听力损失组患者的所有诊断代码的对数频率，并与稳定听力损失组进行了比较。根据线性回归分析的结果，提取了与胆脂瘤相关的进行性听力损失（n=58）和稳定性听力损失（n=55）组的纵向听力学空气和骨传导阈值，以进一步分析听力随时间的变化。线性回归分析表明，胆脂瘤的诊断编码与儿童进行性感音神经性听力损失有关。纵向听力学数据显示，在诊断为胆脂瘤的儿童中，隐性骨传导敏感性的变化与进行性感音神经性听力损失一致。另外的分析表明，乳突切除手术似乎并没有导致观察到的进行性听力损失，而且大量伴有进行性听力损失的胆脂瘤患者在第一次测试时听力阈值正常。统计分析表明胆脂瘤与儿童进行性感音神经性听力损失之间存在关联。这些发现提示，诊断为胆脂瘤的儿童发生进行性感音神经性听力损失的风险可能增加，即使在建立了正常的掩面骨传导基线后，也应继续监测。
This study identified an association between cholesteatoma and progressive sensorineural hearing loss using a large pediatric longitudinal audiologic dataset. Cholesteatoma is a potential sequelae of chronic otitis media with effusion, a commonly observed auditory pathology that can contribute to hearing loss in children. The purpose of this report is to (i) describe the process of identifying the association between cholesteatoma and progressive sensorineural hearing loss in a large pediatric dataset and (ii) describe the audiologic data acquired over time in patients identified with cholesteatoma-associated progressive sensorineural hearing loss. Records of patients included in the Audiologic and Genetics Database (n=175,215 patients) were examined using specified criteria defining progressive hearing loss. A linear regression model examined the log frequency of all diagnostic codes in the electronic health record assigned to patients for a progressive hearing loss cohort compared to a stable hearing loss group. Based on findings from the linear regression analysis, longitudinal audiometric air- and bone-conduction thresholds were extracted for groups of subjects with cholesteatoma-associated progressive (n=58 subjects) and stable (n=55 subjects) hearing loss to further analyze changes in hearing over time. The linear regression analyses identified that diagnostic codes for cholesteatoma were associated with progressive sensorineural hearing loss in children. The longitudinal audiometric data demonstrated within-subject changes in masked bone-conduction sensitivity consistent with progressive sensorineural hearing loss in children diagnosed with cholesteatoma. Additional analyses showed that mastoidectomy surgeries did not appear to contribute to the observed progressive hearing loss and that a high number of cholesteatoma patients with progressive hearing loss had normal hearing thresholds at their first test. The statistical analyses demonstrated an association between cholesteatoma and pediatric progressive sensorineural hearing loss. These findings inform clinical management by suggesting that children with cholesteatoma diagnoses may be at increased risk for progressive sensorineural hearing loss and should receive continued monitoring even after a normal masked bone-conduction baseline has been established.