Otology & Neurotology最新文献

{"title":"Anatomy-Based Fitting in Cochlear Implants: Potential for Optimizing Postoperative Outcomes: A Pilot Study.","authors":"Nina Rubicz, Belinda Bauer, Maximilian Meng, Paul Martin Zwittag, Nikolaus Poier-Fabian","doi":"10.1097/MAO.0000000000004586","DOIUrl":"10.1097/MAO.0000000000004586","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether there is a difference in frequency parameters between anatomy-based fitting (ABF) using a preoperative CT scan and clinically based fitting (CBF).</p><p><strong>Study design: </strong>Monocentric retrospective registry study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Patients: </strong>23 CI recipients between 2004 and 2021.</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Comparison between frequency maps: CBF versus ABF. The frequency parameters used for ABF were estimated based on preoperative CT scans and implanted electrodes.</p><p><strong>Results: </strong>All electrode contact frequencies were significantly different between ABF and CBF maps. When the dataset was manually analyzed, 84% (n = 233) of the predicted electrode location frequencies were outside their allocated frequency band in the clinical fitting map.</p><p><strong>Conclusions: </strong>Setting the CI filter bank frequencies based on preoperative electrode location estimates could be a useful alternative when postoperative CT or DVT imaging is not feasible or unavailable. This can serve as a good starting point when trying to reduce frequency-to-place mismatch between frequency allocations of the fitting filter bank and the tonotopy of the cochlea.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1095-1100"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Versus Microscopic Tympanoplasty: A Single-Blinded Randomized Comparative Trial.","authors":"Aparna Govindan, Mia Saade, Jennifer Ren, Vivian F Kaul, Zachary G Schwam, Enrique R Perez, Maura K Cosetti, George Wanna","doi":"10.1097/MAO.0000000000004590","DOIUrl":"10.1097/MAO.0000000000004590","url":null,"abstract":"<p><strong>Objective: </strong>To provide prospective evidence comparing differences in audiometric and patient-reported outcomes following endoscopic and microscopic tympanoplasty techniques.</p><p><strong>Study design: </strong>Single-blinded prospective randomized comparative trial.</p><p><strong>Setting: </strong>Tertiary care center between 2022 and 2023.</p><p><strong>Patients: </strong>English- and Spanish-speaking adults undergoing transcanal tympanoplasty for dry tympanic membrane perforation (without cholesteatoma or chronic ear disease).</p><p><strong>Intervention: </strong>Endoscopic or microscopic tympanoplasty.</p><p><strong>Main outcome measures: </strong>The primary outcome was air-bone gap change at 3 months. Secondary measures included speech recognition thresholds (SRT), word recognition scores (WRS), and patient-reported outcome measures (PROMs), including visual analog scale (VAS) of pain, Return to Work Self-Efficacy (RTWSE-19), and Glasgow Benefit Inventory (GBI).</p><p><strong>Results: </strong>Thirty-eight adults (mean age, 39.9 yr; range, 21-74 yr) were enrolled. Fifteen received microscopy, and 16 received endoscopy. Seven were excluded from the analysis: three required a post-auricular incision, and four were lost to follow-up without postoperative audiograms. Only PROMs collected within 3 weeks postoperatively were analyzed due to high participant dropout rates beyond 3 weeks. There were no differences in any audiometric or patient-reported outcomes between treatment groups ( p > 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that transcanal endoscopic and microscopic approaches to tympanoplasty do not differ in postoperative audiometric outcomes or PROMs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1117-1123"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Lidocaine on Quinine-Induced Tinnitus in Guinea Pigs: A Focus on the Auditory Cortex.","authors":"Mutsumi Kenmochi, Kentaro Ochi, Hirotsugu Kinoshita, Shigeru Kasugai, Manabu Nakamura, Manabu Komori","doi":"10.1097/MAO.0000000000004616","DOIUrl":"10.1097/MAO.0000000000004616","url":null,"abstract":"<p><strong>Hypothesis: </strong>This study investigated whether intravenous lidocaine reverses auditory cortex changes induced by systemic quinine administration.</p><p><strong>Background: </strong>Quinine, like salicylate, is known to induce tinnitus. Previous studies have shown that salicylate-induced changes in the auditory cortex can be reversed by lidocaine, a compound known to suppress tinnitus. If lidocaine also reverses quinine-induced changes, it would further support the association between these neural changes and the presence of tinnitus.</p><p><strong>Methods: </strong>Healthy male albino Hartley guinea pigs received systemic quinine, followed by intravenous lidocaine. Extracellular recordings were obtained from the primary auditory cortex and dorsocaudal areas across four sessions: baseline (control), two post-quinine sessions, and a post-lidocaine session.</p><p><strong>Results: </strong>A total of 156 single units in the primary auditory cortex and 159 single units in the dorsocaudal areas were recorded from 10 guinea pigs. Quinine administration significantly elevated threshold in both primary auditory cortex (first post-quinine session: mean, 3.2 dB; second post-quinine session: mean, 16.2 dB) and dorsocaudal areas (first post-quinine session: mean, 3.9 dB; second post-quinine session: mean, 11.0 dB), but lidocaine did not induce further threshold changes. However, quinine-induced alterations in Q10dB value and spontaneous firing activity were reversed by lidocaine in both the primary auditory cortex and dorsocaudal areas.</p><p><strong>Conclusion: </strong>The reversal of quinine-induced changes in Q10dB value and spontaneous firing activity by lidocaine suggests that these neural alterations are related to tinnitus. Similar results with salicylate further support the association between cortical changes and tinnitus, pointing to a possible shared central mechanism.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e437-e442"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapedotomy in Otosclerosis: A GRADE-Guided Systematic Review and Meta-analysis of Endoscopy vs. Microscopy.","authors":"Mina Botros, Merna Raafat Roshdy, Abanoub Mokhles, George Karas, Samer Sameh Bedwany","doi":"10.1097/MAO.0000000000004606","DOIUrl":"10.1097/MAO.0000000000004606","url":null,"abstract":"<p><strong>Objective: </strong>A definitive comparison between endoscopic and microscopic techniques in stapes surgery for otosclerosis patients regarding safety and efficacy, we exclusively included randomized controlled trials (RCTs) and applied the GRADE methodology to assess the certainty of the evidence in our conclusions.</p><p><strong>Databases reviewed: </strong>A search across PubMed, Web of Science, Scopus, and Cochrane Library was conducted from inception to December 2024. We included only RCTs that compared both techniques of stapes surgery in otosclerosis patients.</p><p><strong>Methods: </strong>Primary outcomes were change in air-bone gap (ABG), postoperative ABG, chorda tympani nerve (CTN) manipulation/handling, CTN injury, and postoperative dysgeusia. Secondary outcomes focused on operation time, visibility of incudostapedial complex before suprastructure removal, scutum curettage, postoperative pain and vertigo, hearing improvement, facial nerve injury, tympanic membrane perforation, gusher phenomenon, and tympanomeatal flap tear.</p><p><strong>Results: </strong>Eleven RCTs, with a total of 532 patients, met the inclusion criteria. For mean change in ABG (1.35 [95% CI (-0.22, 2.91)], p = 0.09), postoperative ABG (-0.51 [95% CI (-1.16, 0.14)], p = 0.12), CTN injury, operative time, hearing improvement, and postoperative vertigo, no significant differences were found between both approaches. However, endoscopy was significantly favored over microscopy regarding CTN manipulation RR = 0.63 [95% CI (0.45, 0.88), p < 0.01], postoperative dysgeusia RR = 0.24 [95% CI (0.14, 0.43), p < 0.01], visibility of Incudostapedial complex, scutum curettage, and postoperative pain.</p><p><strong>Conclusion: </strong>Similar auditory results following both techniques of stapes surgery in otosclerosis patients. However, endoscopy seems superior regarding CTN manipulation, scutum curettage, postoperative dysgeusia, and pain.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1022-1030"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Treatment of Middle Ear Cholesterol Granuloma Involving the Middle Cranial fossa.","authors":"Shengqing Nian, Chenyu Chen, Yuqing Chen, Xihang Chen, Chang Lin","doi":"10.1097/MAO.0000000000004551","DOIUrl":"10.1097/MAO.0000000000004551","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical features, surgical options, and prognosis of middle ear cholesterol granuloma involving the middle cranial fossa.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Subjects and methods: </strong>Medical records of three patients with giant skull base cholesterol granuloma from 2006 to 2017 were retrospectively analyzed. The symptoms, signs, radiological features, treatment options, and prognosis were summarized.</p><p><strong>Results: </strong>All patients underwent radical mastoidectomy and resection of skull base lesions by means of a retroauricular approach. Postoperative pathological diagnosis showed cholesterol granuloma. All patients were followed for more than 1 year. The symptoms were relieved, and there was no recurrence. Postoperative imaging showed that the skull base lesions were cleared and the compressed brain tissue recovered.</p><p><strong>Conclusion: </strong>Patients with middle ear cholesterol granuloma involving the middle cranial fossa can be operated on by retroauricular approach. It can reduce the trauma of craniotomy and obtain good curative effect.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e419-e422"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Cortical Auditory Evoked Potentials in Active Middle Ear and Bone Conduction Implant Users: An Objective Method to Optimize the Fitting.","authors":"Marcus Voola, Lorenzo Vignali, Hamidreza Mojallal, Caris Bogdanov, Dayse Távora-Vieira","doi":"10.1097/MAO.0000000000004581","DOIUrl":"10.1097/MAO.0000000000004581","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate whether cortical auditory evoked potential (CAEP) measures could be used to optimize active middle ear implant (aMEI) and bone conduction implant (BCI) fitting, with the goal of improving hearing outcomes in adults.</p><p><strong>Design: </strong>CAEPs were measured in response to LING sounds /OO/, /AH/, and /SH/ presented in sound field. If CAEP responses were recorded for all sounds, no map adjustments were performed. If a CAEP response was absent for one or more sounds, map parameters were optimized until a CAEP response could be induced. Functional outcomes were measured as pre- vs postoptimization adaptive speech-in-noise results. Subjective feedback was also collected.</p><p><strong>Results: </strong>Of the 15 participants, one was excluded from the study, three did not need optimization, nine were successfully optimized using CAEP measurements, and two could not be optimized. Comparison of CAEP morphology showed significant differences pre- vs postoptimization for middle- and high-frequency sounds (i.e., /AH/ and /SH/). Speech-in-noise testing revealed significant improvements pre- vs postoptimization, and participants were generally satisfied with the overall procedure.</p><p><strong>Conclusion: </strong>These findings demonstrated that middle- and high-frequency tokens could be successfully optimized using CAEPs, resulting in significant improvements in hearing performance. Our results support the use of CAEPs for the optimization of aMEI and BCI adult users' fitting.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1037-1044"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photon-Counting CT Reveals Radiologically Occult Otospongiosis: A Case Report.","authors":"Anna Dordonnat, Neil Grislain, Gabriel Garcia, Jean-Noël Vallée, Michael Eliezer","doi":"10.1097/MAO.0000000000004599","DOIUrl":"10.1097/MAO.0000000000004599","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e447-e448"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Novel Transcanal Catheter for Delivery of Hypothermia to the Inner Ear.","authors":"Pavan S Krishnan, Maria Fernanda Yepes, Curtis S King, Suhrud M Rajguru","doi":"10.1097/MAO.0000000000004596","DOIUrl":"10.1097/MAO.0000000000004596","url":null,"abstract":"<p><strong>Abstract: </strong>Mild therapeutic hypothermia (MTH) has demonstrated neuroprotective effects in the cochlea, particularly against noise-induced and electrode insertion trauma, by reducing inflammation and oxidative stress. Prior cadaveric studies have shown that localized cochlear cooling can be achieved using a probe placed on the promontory or a surface cooling device placed on the mastoid. While the effects of MTH on the vestibular system remain unstudied, its proximity and physiological similarity to the cochlea suggest potential benefits. We aimed to develop the first noninvasive, localized MTH device for use in the clinical environment, capable of targeting both cochlear and vestibular structures without obstructing the surgical field. A custom-designed, saline-filled cooling catheter with a balloon tip was designed to be positioned in the ear canal adjacent to the tympanic membrane. Temperature measurements were recorded from the round window, oval window, and all three semicircular canals, and compared to whole-head temperature fluctuations measured via the nasopharynx in human cadaver samples. Thermistors recorded an average temperature reduction of 4-6°C during a 30-minute protocol in cadaver heads. Nasopharyngeal temperature remained stable throughout. Furthermore, a numerical model was used to evaluate the theoretical temperature reduction achieved through ear canal cooling. The computational model further validated the experimental measurements from the cochlea. In conclusion, these findings demonstrate that cochlear and vestibular hypothermia can be effectively induced using an external cooling system positioned in the ear canal, supporting the development of a more accessible and practical clinical approach to protect the inner ear during invasive procedures.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1171-1177"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Nerve Management and Hearing Preservation and Rehabilitation in Petrous Bone Cholesteatoma (PBC).","authors":"Monica Rueda Vega, M Montserrat Asensi Diaz, Carlos Martín Oviedo, Ignacio Arístegui Torrano, Miguel Arístegui Ruiz","doi":"10.1097/MAO.0000000000004592","DOIUrl":"10.1097/MAO.0000000000004592","url":null,"abstract":"<p><strong>Objective: </strong>To assess our experience in the management of the facial nerve and hearing rehabilitation in patients with petrous bone cholesteatoma (PBC).</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>PBC cases managed by the senior authors between 1995 and 2024.</p><p><strong>Main outcome measures: </strong>Clinical presentation, Sanna's classification, presurgical and postsurgical audiometry and facial function, surgical approach (including assisted endoscopic techniques), recurrence rates, intraoperative findings and facial nerve management, hearing rehabilitation, facial nerve repair techniques.</p><p><strong>Results: </strong>Ninety-two cases were reported. The most common type was supralabyrinthine PBCs (40.43%). Hearing loss was present in almost all the patients (98.91%), with moderate mixed hearing loss (35.87%) being the most frequent preoperative audiometric finding. Hearing rehabilitation was performed in 11 patients (8 cochlear implants, 3 bone conduction implants). Postoperative normal function was achieved in 49 cases (53.26%). Intraoperatively, the facial nerve was interrupted in eight cases (13.3%). In five cases, a facial-hypoglossal nerve anastomosis was performed. Facial palsy was statistically more frequent in massive and supralabyrinthine PBCs ( p = 0.048). There is a statistically significant relation between preoperative and postoperative facial function and facial nerve intraoperative findings ( p = 0.001 and p = 0.000, respectively).</p><p><strong>Conclusions: </strong>Advances in surgical techniques and early diagnosis have improved facial nerve preservation. However, surgical repair remains essential for patients with significant preoperative facial nerve involvement. On the other hand, although the primary focus in PBC surgery is complete disease removal and preservation of facial nerve function, the opportunity to rehabilitate hearing should not be overlooked.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1150-1157"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of MRI Cochlear FLAIR Signal on Hearing Preservation after Middle Fossa Vestibular Schwannoma Resection.","authors":"Nicole Ewer, Samira Takkoush, Jason L Steele, Heather J Smith, Melissa Shuhui Lee, Mana Espahbodi, Richard H Wiggins, William T Couldwell, Richard K Gurgel, Neil S Patel","doi":"10.1097/MAO.0000000000004619","DOIUrl":"10.1097/MAO.0000000000004619","url":null,"abstract":"<p><strong>Objective: </strong>Literature is limited regarding the relationship between cochlear magnetic resonance imaging fluid-attenuated inversion recovery (FLAIR) signal and hearing preservation after resection of vestibular schwannoma (VS). We hypothesize that increased preoperative FLAIR signal is associated with decreased odds of hearing preservation.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single academic tertiary/quaternary care center.</p><p><strong>Patients: </strong>Subjects with histologically confirmed intracanalicular VS (without extension into the cerebellopontine angle).</p><p><strong>Intervention: </strong>Microsurgical resection via middle fossa approach.</p><p><strong>Main outcome measures: </strong>A review of demographic, clinical, radiographic, and audiometric outcomes were performed. Hearing preservation was defined as American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) class A or B hearing. Binary logistic regression analysis was performed with SPSS version 29.</p><p><strong>Results: </strong>Twenty-seven subjects met inclusion criteria with median age at time of surgery of 47 (interquartile range [IQR]: 38-54) years; 92.60% were White; 66.67% had AAO-HNS class A, and 33.33% had class B hearing. Postoperatively, at median (IQR) of 11.50 (2.10-38.50) months, 44.40% had class A or B hearing. On logistic regression analysis, a ratio of cochlea-to-brainstem FLAIR signal greater than 0.6 was associated with decreased odds of hearing preservation at 11.50 months-odds ratio, 0.13; 95% confidence interval, 0.02-0.84. Age, sex, surgery duration, tumor volume and linear dimension, fundal cap of cerebrospinal fluid, and extent of resection were not associated with hearing preservation.</p><p><strong>Conclusion: </strong>Increased cochlear FLAIR signal on preoperative imaging is associated with decreased likelihood of hearing preservation after resection of intracanalicular, sporadic VS via middle fossa approach.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e428-e433"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}