耳硬化症中的Symons和Fanning分类及其与听力学参数、镫骨足板厚度和圆窗受累的关系。

文献信息

中文摘要

引言： 耳硬化症是一种临床诊断，尽管术前大多进行影像学检查。放射学分类和发现与听力参数的相关性不一致。本研究的目的是探讨来自不同科室的两名评估者对广泛使用的Symons和Fanning分类（SFC）的评估者间和评估者内信度，并将其与其他放射学特征和听力参数相关联。
方法： 这是一项回顾性数据分析，在单一三级转诊中心对56例患者的63只手术确诊的耳硬化症耳进行。放射学分类和发现由两名研究者（一名神经放射科医生和一名耳鼻喉科专家）独立从术前锥形束计算机断层扫描中评估。比较Symons和Fanning分类的评估者间和评估者内信度及其与听力水平、圆窗受累和镫骨足板厚度的相关性。
结果： 评估者间信度在六个月期间略有增加，但在两个时间点均被认为是弱的。每位评估者的SFC之间、评估者匹配与听力水平之间均无相关性。16%（10/63）的患者可见圆窗受累，且与术前听力水平或听力结果无关联。根据SFC的较高分级与镫骨足板厚度无关联。
结论： 当由来自不同学科的两名专家独立进行分级时，SFC在锥形束计算机断层扫描（CBCT）上的可重复性有限。在放射学分期与镫骨足板厚度之间，以及与听力水平或圆窗受累的关系中，未观察到显著关联。评估者或时间点不是决定性因素。这些发现表明，该分类对术前听力咨询的预测价值仍然有条件地适用。

英文摘要

Introduction Otosclerosis is a clinical diagnosis despite mostly performed preoperative imaging. Radiological classifications and findings correlate heterogeneously with audiometric parameters. The objective of this study was to investigate the inter- and intrarater reliability between two raters of different departments regarding the widely used Symons and Fanning Classification (SFC) and correlate this with further radiological features and audiometric parameter. Methods This was a retrospective data analysis conducted on 63 surgical confirmed otosclerotic ears from 56 patients in a single tertiary referral center. Radiological classification and findings were assessed independently by two investigators, a neuroradiologist and ear-, nose and throat specialist, from a preoperative cone beam computed tomography. Inter- and intrarater reliability of the Symons and Fanning classification and its correlation were compared with hearing level, round window involvement, and stapes footplate thickness. Results Interrater reliability slightly increased over a six-month period and was considered to be weak at both time points. There was no correlation between the SFC of each rater, between the rater matches and the hearing level. Round window involvement was seen in 16% (10/63) of patients and showed no association with preoperative hearing level or audiometric outcome. Higher grading according to the SFC revealed no association with stapes footplate thickness. Conclusion The reproducibility of the SFC on cone beam computed tomography (CBCT) has found to be limited when grading was performed independently by two specialists from different disciplines. No significant associations were observed between radiologic staging and stapes footplate thickness, and in relation to hearing level or round window involvement. The rater or timepoint was no decisive factor. These findings indicate that the predictive value of the classification for preoperative audiologic counselling remains conditionally applicable.