Hearing levels in patients with microtia: Correlation with temporal bone malformation
Hearing levels in patients with microtia: Correlation with temporal bone malformation
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DOI：
10.1097/mlg.0b013e31802ca4d4
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发表时间：
2007-03-01
期刊：
影响因子：
2.6
通讯作者：
Yamasoba, Tatsuya
中科院分区：
文献类型：
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作者：
Ishimoto, Shin-ichi;Ito, Ken;Yamasoba, Tatsuya
objective.探讨小耳畸形患者听力水平与颞骨异常的关系。研究设计. 1992年至2004年的回顾性病例系列研究。设置.学术、三级保健转诊医疗中心。患者我们评估了89例小耳畸形患者（68例男性，21例女性;平均年龄，11岁;范围，5 - 44岁）的115耳。主要结局指标。对小耳畸形患者进行听力水平检查。颞骨的发育异常通过Jahrsdoerfer计算机断层扫描（CT）评分系统使用颞骨的高分辨率CT（HRCT）扫描进行评价。颞骨畸形评分分为四个亚组：听骨发育、与耳蜗相连的窗、中耳腔通气和面神经畸变。根据外耳道形态分为外耳道狭窄组和外耳道闭锁组。我们还评估了狭窄组和闭锁组的听力水平与HRCT表现的四个分项得分之间的关系。结果如下：听力水平与HRCT评分系统总分及小耳畸形马克思分型严重程度无相关性。关于与听小骨相关的小计点（4分），狭窄组中得分较低（= 2）的耳朵的听力水平（54.0 +/-2.8 dB）。在闭锁组中，听力水平在低评分耳中为64.3 +/-2.2 dB，在高评分耳中为62.3 +/-1.1 dB（P> 0.5）。对于与耳蜗连接的窗相关的小计点（2分），狭窄组中低评分（0）耳的听力水平为64.8 +/-2.6 dB，高评分（>= 1）耳的听力水平为55.9 +/-2.4 dB。在闭锁组中，听力水平为67.7 +/-2.3分贝的耳朵与低分数和61.5 +/-1.0耳朵与高分数。狭窄组（P = 0.03）和闭锁组（P = 0.009）中低评分和高评分耳之间存在显著差异。在中耳腔通气和面神经畸变相关的分项得分方面，低分耳与高分耳之间无显著性差异。结论小耳畸形的听力水平与卵圆窗的形成和听骨发育相关，但与中耳通气程度、面神经畸变或小耳畸形的严重程度无关。听力水平也可以作为一个指标，如HRCT结果，以确定是否受试者的听力将可能改善后重建手术。
Objective. To evaluate the relationship between hearing level and temporal bone abnormalities in patients with microtia. Study Design. Retrospective case series study between 1992 and 2004. Setting. Academic, tertiary care referral medical center. Patients. We evaluated 115 ears of 89 patients (68 males, 21 females; mean age, 11 yr; range, 5-44 yr) with microtia. Main Outcome Measures. Hearing level was examined in patients with microtia. Developmental abnormalities of the temporal bone were evaluated by Jahrsdoerfer's computed tomography (CT) scoring system using high-resolution CT (HRCT) scans of the temporal bone. Temporal bone malformation scores were divided into four subgroups: ossicular development, windows connected to the cochlea, aeration of the middle ear cavity, and facial nerve aberration. Patients were divided into the stenosis and atresia groups on the basis of the appearance of the external auditory canal (EAC). We also evaluated the relationships between hearing level and four subtotal scores of the HRCT findings in the stenosis and atresia groups. Results: There was no relationship between hearing level and total points of HRCT scoring system or between hearing level and severity of microtia scored by Marx classification. With regard to subtotal points related to ossicles (4 points), the hearing level in ears with low scores (= 2) (54.0 +/- 2.8 dB) in the stenosis group. In the atresia group, the hearing level was 64.3 +/- 2.2 dB in ears with low scores and 62.3 +/- 1.1 in ears with high scores (P > .5). As for subtotal points related to the windows connected to cochlea (2 points), the hearing level was 64.8 +/- 2.6 dB in ears with low scores (0) and 55.9 +/- 2.4 dB in ears with high scores (> = 1) in the stenosis group. In the atresia group, the hearing level was 67.7 +/- 2.3 dB in ears with low scores and 61.5 +/- 1.0 in ears with high scores. There was significant difference between ears with low and high scores in the stenosis group (P = .03) and atresia group (P = .009). There was no significant difference between ears with low and high scores with respect to the subtotal points related to aeration of the middle ear cavity and aberration of the facial nerve. Conclusion. The hearing level in microtic ears correlated with the formation of oval/round windows and ossicular development but not with the degree of middle ear aeration, facial nerve aberration, or severity of microtia. The hearing level can also serve as an indictor, such as the HRCT findings, to determine whether a subject's hearing will likely improve after reconstructive surgery.