预防性尼莫地平用于前庭神经鞘瘤听力保留：一项回顾性队列研究。
Prophylactic Nimodipine for Hearing Preservation in Vestibular Schwannoma: A Retrospective Cohort Study.
文献信息
| PMID | 42806561 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Clifford Jiajun He |
| 作者单位 | School of Medicine, University of California San Diego, La Jolla, CA, USA. |
| 期刊 | The Annals of otology, rhinology, and laryngology |
| SCI 分区 | Q3 |
| IF | 1.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 前庭神经鞘瘤手术对保留听力和面神经功能构成重大挑战。预防性尼莫地平已被研究作为听力保留手术后保护颅神经功能的药物策略，但尚未得到充分评估。本研究旨在评估预防性尼莫地平在促进前庭神经鞘瘤手术后听力和面神经功能方面的作用，并评估尼莫地平给药与患者结局之间的剂量-反应关系。
方法： 我们对2017年11月至2024年12月期间在一家三级医疗中心接受听力保留手术的前庭神经鞘瘤患者队列进行了回顾性分析。听力结局采用言语识别率和纯音测听评估，面神经功能结局采用House-Brackmann评分评估。进行回归分析以确定尼莫地平对听力保留的影响，并评估剂量-反应关系。
结果： 研究纳入58例对照患者和340例尼莫地平治疗患者。尼莫地平治疗显著改善了颅神经结局。与对照组相比，尼莫地平治疗患者保留言语识别率的几率高2.0倍（OR：1.92，95% CI：1.08-3.44，P = .027），保留纯音平均值的几率高1.5倍（OR：1.49，95% CI：0.84-2.66，P = .17），保留面神经功能的几率高2.0倍（OR：2.02，95% CI：1.10-3.73，P = .024）。剂量-反应分析显示，每增加一剂尼莫地平与言语识别改善2.3%（P < .001）、纯音平均值保留改善1.7%（P < .001）以及面神经保留改善1.1%（P = .049）相关。
结论： 预防性尼莫地平在听力保留前庭神经鞘瘤手术后增强术后颅神经功能方面显示出潜在疗效。这些发现支持通过前瞻性研究进一步验证尼莫地平的临床效用。
英文摘要
BACKGROUND: Vestibular schwannoma surgery poses a significant challenge for hearing and facial function preservation. Prophylactic nimodipine has been studied as a pharmacologic strategy to protect cranial nerve function after hearing preservation surgery, but it has not been thoroughly evaluated. This study aimed to assess the role of prophylactic nimodipine in promoting hearing and facial function following vestibular schwannoma surgery and to evaluate the dose-response relationship between nimodipine administration and patient outcomes.
METHODS: We conducted a retrospective analysis on a cohort of vestibular schwannoma patients who underwent hearing preservation surgery at a tertiary care hospital between November 2017 and December 2024. Hearing outcomes were assessed using word recognition scores and pure tone audiometry, and facial function outcomes were assessed with House-Brackmann Score. Regression analyses were performed to determine the impact of nimodipine on hearing preservation and to evaluate dose-response relationships.
RESULTS: The study included 58 control patients and 340 nimodipine-treated patients. Nimodipine treatment significantly improved cranial nerve outcomes. Compared to controls, nimodipine-treated patients had 2.0 times greater odds of preserving word recognition score (OR: 1.92, 95% CI: 1.08-3.44, P = .027), 1.5 times greater odds of preserving pure tone average (OR: 1.49, 95% CI: 0.84-2.66, P = .17), and 2.0 times greater odds of preserving facial nerve function (OR: 2.02, 95% CI: 1.10-3.73, P = .024). Dose-response analyses revealed that each additional nimodipine dose was associated with a 2.3% improvement in word recognition (P < .001), 1.7% improvement in pure tone average preservation (P < .001), and 1.1% improvement in facial nerve preservation (P = .049).
CONCLUSION: Prophylactic nimodipine demonstrates potential efficacy in enhancing post-operative cranial nerve function after hearing preservation vestibular schwannoma surgery. These findings support further investigation through prospective studies to confirm nimodipine's clinical utility.