儿童颞骨骨折伴听力损失的长期预后：多国数据库分析的结果。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-01-01 DOI:10.1016/j.ijporl.2024.112186

Jason L. Steele , Heather J. Smith , Samira Takkoush , Jumah G. Ahmad , Zachary D. Urdang , Neil S. Patel , Richard K. Gurgel , Mana Espahbodi

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引用次数: 0

摘要

儿童颞骨骨折（tbf）可导致不良后果，包括脑膜炎、需要人工耳蜗植入的严重感音神经性听力损失（CI）、面神经无力、脑脊液（CSF）泄漏和迷路炎。本研究的目的是确定伴有听力损失的tbf患者这些结果的风险。方法：使用多国TriNetX数据库，对年龄小于18岁的患有其他颅底骨折和听力损失诊断代码的患者进行回顾性队列研究，以作为TBF的近似值。该分类排除了所有无听力损失的tbf。选择年龄和性别匹配的对照队列，不使用上述诊断代码。95%以上的患者数据来自2006年至今，每个卫生保健组织平均有12-14年的数据。测量结果包括脑膜炎、CI、面神经紊乱（包括面神经无力、眼lagophthalmos和眼lagophthalmos的眼睑重量放置）、脑脊液漏和TBF后迷路炎。在1:1倾向评分匹配（PSM）后计算年龄和性别的风险比。结果：TriNetX确定了2739例有TBF的儿童患者（平均年龄7.61±4.39岁）和2739例年龄和性别匹配的无TBF的儿童患者（平均年龄7.58±4.37岁）。有TBF的患者在任何时候发生脑膜炎（RR: 2.90, 95% CI: 1.42-5.94）和面神经紊乱（RR: 13.44, 95% CI: 8.83-20.45）的风险都高于无TBF的患者。迷路炎、CI或脑脊液泄漏没有匹配的结果，因为在儿童TBF队列中有多个病例，而在对照队列中为零。结果在PSM之前，与没有TBF的队列相比，儿童TBF队列中迷路炎（RR: 43.12, 95% CI: 23.17-80.27）、CI （RR: 21.61, 95% CI: 13.03-35.84）和CSF泄漏（89.08,95% CI: 67.71-117.20）的风险增加。讨论：持续TBF并伴有听力损失的儿科患者随后发生脑膜炎和面神经疾病的风险增加，也可能增加迷路炎、脑脊液泄漏和接受CI的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Long-term outcomes of pediatric temporal bone fractures with hearing loss: Results of a multinational database analysis

Introduction

Pediatric temporal bone fractures (TBFs) can result in adverse outcomes including meningitis, significant sensorineural hearing loss requiring cochlear implantation (CI), facial nerve weakness, cerebrospinal fluid (CSF) leak, and labyrinthitis. The objective of this study is to determine the risks of these outcomes for TBFs with hearing loss.

Methods

Using the multinational TriNetX database, a retrospective cohort study was performed of patients less than 18 years old with diagnostic codes for other fracture of base of skull and hearing loss to serve as an approximation of TBF. This classification excluded all TBFs without hearing loss. An age- and sex-matched control cohort was selected without the above-mentioned diagnostic codes. More than 95 % of patient data used is from 2006-present, with an average of 12–14 years of data per health care organization. Measured outcomes included meningitis, CI, facial nerve disorders (including facial nerve weakness, lagophthalmos, and eyelid weight placement for lagophthalmos), CSF leak and labyrinthitis after TBF. Risk ratios were calculated after 1:1 propensity-score matching (PSM) for age and sex.

Results

TriNetX identified 2739 pediatric patients (mean age of 7.61 ± 4.39 years) with TBF and an age- and sex-matched cohort of 2739 pediatric patients without TBF (mean age of 7.58 ± 4.37 years). Those with TBF had a greater risk of developing meningitis (RR: 2.90, 95 % CI: 1.42–5.94) and facial nerve disorders (RR: 13.44, 95 % CI: 8.83–20.45) at any time than those without TBF. Matched results were not available for labyrinthitis, CI or CSF leak, as there were multiple instances in the Pediatric TBF cohort versus zero instances in the Control cohort. Results prior to PSM demonstrated an increased risk for labyrinthitis (RR: 43.12, 95 % CI: 23.17–80.27), CI (RR: 21.61, 95 % CI: 13.03–35.84) and CSF leak (89.08, 95 % CI: 67.71–117.20) in the pediatric TBF cohort compared with the cohort without TBF.

Discussion

Pediatric patients who sustain TBF with hearing loss are at increased risk of subsequent meningitis and facial nerve disorders and may also be at increased risk of labyrinthitis, CSF leak, and undergoing CI.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.