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鼓膜通气管置入术作为梅尼埃病患者的一种治疗方式:7例患者的短期和长期随访研究

Insertion of tympanic ventilation tubes as a treating modality for patients with Meniere's disease: a short- and long-term follow-up study in seven cases.

作者信息

Sugawara Komei, Kitamura Ken, Ishida Takashi, Sejima Takayuki

机构信息

Department of Otolaryngology-Head and Neck Surgery, Jichi Medical School, Tochigi, Japan

出版信息

Auris Nasus Larynx. 2003 Feb;30(1):25-8. doi: 10.1016/s0385-8146(02)00105-0.

Abstract

OBJECTIVES

As a treatment for patients with Meniere's disease, insertion of a ventilating tube in tympanic membrane was carried out, and the effect of the therapeutic modality was analysed.

METHODS

Seven patients (four males and three females, age ranged 35-62 years) with active Meniere's disease were placed with ventilating tubes in the affected ear and postoperative change in symptoms, i.e. incapacitating vertigo and hearing loss were investigated. Disease severity was scored and evaluated pre- and postoperatively under the guidelines proposed by the Committee on Hearing and Equilibrium in the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, 1985).

RESULTS

Of the seven cases, the number of patients and the degree in controlling vertigo after the treatment were: at 24 months (short-term) five cases with substantial, one with limited and one with insignificant control, then at 42 months (long- term) four cases with substantial, three with limited control, respectively. The degree of disability in patients at 24 and 42 months of the treatment was compatible with the level of vertigo controlling. On the other hand, patients' hearing level was not affected by the treatment.

CONCLUSIONS

Exact explanation for the effect of ventilating tubes in tympanic membrane is vague and its therapeutic effect was limited. However, at least this treatment might represent a short-term effect for the reduction of persistent vertigo in some patients with Meniere's disease and so it might become a treatment option because of its simple and less-invasive procedure.

摘要

目的

对梅尼埃病患者实施鼓膜置管治疗,并分析该治疗方式的效果。

方法

对7例(4例男性,3例女性,年龄35 - 62岁)处于活动期的梅尼埃病患者患耳进行鼓膜置管,并调查术后症状变化,即失能性眩晕和听力损失情况。根据美国耳鼻咽喉-头颈外科学会听力与平衡委员会(AAO-HNS,1985年)提出的指南,在术前和术后对疾病严重程度进行评分和评估。

结果

7例患者中,治疗后眩晕控制情况及患者数量为:24个月(短期)时,5例显著控制,1例部分控制,1例控制不佳;42个月(长期)时,分别为4例显著控制,3例部分控制。治疗24个月和42个月时患者的失能程度与眩晕控制水平相符。另一方面,患者的听力水平未受该治疗影响。

结论

鼓膜置管效果的确切机制尚不明确,其治疗效果有限。然而,至少该治疗可能对部分梅尼埃病患者的持续性眩晕有短期缓解作用,且因其操作简单、侵入性小,可能成为一种治疗选择。

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