听神经瘤乙状窦后入路手术后听力保留影响因素分析
目的 筛查乙状窦后入路听神经瘤切除术后听力保留的相关影响因素.方法 纳入2018年1月至2021年1月在首都医科大学附属北京天坛医院行乙状窦后入路手术的317例听神经瘤患者,术前影像学检查评估肿瘤大小(Koos分级)、是否侵袭内听道底部和是否发生囊性变,美国耳鼻咽喉头颈外科学会(AAO-HNS)听力分级评估手术前后听力,单因素和多因素前进法Logistic回归分析筛查乙状窦后入路手术后听力损失相关危险因素.结果 共35例患者实现术后听力保留(AAO-HNS分级A级和B级),整体听力保留率约为11.04％(35/317),均为术前听力正常患者.听力损失组年龄＞45岁(x2=45.648,P=0....
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| Published in | 中国现代神经疾病杂志 Vol. 22; no. 12; pp. 1047 - 1052 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
100070 首都医科大学附属北京天坛医院神经外科
01.12.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1672-6731 |
| DOI | 10.3969/j.issn.1672-6731.2022.12.008 |
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| Abstract | 目的 筛查乙状窦后入路听神经瘤切除术后听力保留的相关影响因素.方法 纳入2018年1月至2021年1月在首都医科大学附属北京天坛医院行乙状窦后入路手术的317例听神经瘤患者,术前影像学检查评估肿瘤大小(Koos分级)、是否侵袭内听道底部和是否发生囊性变,美国耳鼻咽喉头颈外科学会(AAO-HNS)听力分级评估手术前后听力,单因素和多因素前进法Logistic回归分析筛查乙状窦后入路手术后听力损失相关危险因素.结果 共35例患者实现术后听力保留(AAO-HNS分级A级和B级),整体听力保留率约为11.04％(35/317),均为术前听力正常患者.听力损失组年龄＞45岁(x2=45.648,P=0.000)、Koos 分级 3～4 级(x2=41.692,P=0.000)、肿瘤侵袭内听道底部(x2=30.252,P=0.000)、肿瘤囊性变(x2=23.888,P=0.000)和术前听力异常(x2=78.317,P=0.000)比例均高于听力保留组.Logistic 回归分析,年龄＞45 岁(OR=36.211,95％CI:5.006～261.918;P=0.000)、Koos分级3～4级(OR=21.215,95％CI:2.867～156.963;P=0.003)、肿瘤侵袭内听道底部(OR=13.746,95％CI:3.005～62.880;P=0.001)和肿瘤囊性变(OR=8.336,95％CI:1.943～35.770;P=0.004)是乙状窦后入路手术后听力损失的危险因素.结论 对于有听力保留需求的听神经瘤患者,乙状窦后入路手术安全、有效,年龄较小、肿瘤体积较小、肿瘤未侵袭内听道底部和无囊性变的患者更有可能实现术后听力保留. |
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| AbstractList | 目的 筛查乙状窦后入路听神经瘤切除术后听力保留的相关影响因素.方法 纳入2018年1月至2021年1月在首都医科大学附属北京天坛医院行乙状窦后入路手术的317例听神经瘤患者,术前影像学检查评估肿瘤大小(Koos分级)、是否侵袭内听道底部和是否发生囊性变,美国耳鼻咽喉头颈外科学会(AAO-HNS)听力分级评估手术前后听力,单因素和多因素前进法Logistic回归分析筛查乙状窦后入路手术后听力损失相关危险因素.结果 共35例患者实现术后听力保留(AAO-HNS分级A级和B级),整体听力保留率约为11.04％(35/317),均为术前听力正常患者.听力损失组年龄＞45岁(x2=45.648,P=0.000)、Koos 分级 3～4 级(x2=41.692,P=0.000)、肿瘤侵袭内听道底部(x2=30.252,P=0.000)、肿瘤囊性变(x2=23.888,P=0.000)和术前听力异常(x2=78.317,P=0.000)比例均高于听力保留组.Logistic 回归分析,年龄＞45 岁(OR=36.211,95％CI:5.006～261.918;P=0.000)、Koos分级3～4级(OR=21.215,95％CI:2.867～156.963;P=0.003)、肿瘤侵袭内听道底部(OR=13.746,95％CI:3.005～62.880;P=0.001)和肿瘤囊性变(OR=8.336,95％CI:1.943～35.770;P=0.004)是乙状窦后入路手术后听力损失的危险因素.结论 对于有听力保留需求的听神经瘤患者,乙状窦后入路手术安全、有效,年龄较小、肿瘤体积较小、肿瘤未侵袭内听道底部和无囊性变的患者更有可能实现术后听力保留. |
| Author | 严敏君 王兴朝 王博 杨智君 毕智勇 刘丕楠 |
| AuthorAffiliation | 100070 首都医科大学附属北京天坛医院神经外科 |
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| Author_FL | YANG Zhi-jun WANG Xing-chao LIU Pi-nan BI Zhi-yong YAN Min-jun WANG Bo |
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| Keywords | Logistic 模型 显微外科手术 神经瘤,听 听力丧失,功能性 危险因素 小脑脑桥角 |
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| PublicationTitle_FL | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| Snippet | 目的 筛查乙状窦后入路听神经瘤切除术后听力保留的相关影响因素.方法 纳入2018年1月至2021年1月在首都医科大学附属北京天坛医院行乙状窦后入路手术的317例听神经瘤患者,术... |
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| Title | 听神经瘤乙状窦后入路手术后听力保留影响因素分析 |
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