Düwel P, Walther L E, Ilgner J, Westhofen M
Klinik für Hals-, Nasen- und Ohrenheilkunde und Plastische Kopf- und Halschirurgie des Universitätsklinikum Aachen.
Laryngorhinootologie. 2005 Aug;84(8):589-93. doi: 10.1055/s-2005-861248.
Since Dohlmann's investigations the extremely variable interindividual natural course of Menière's disease has been documented. The description of sub-entities of Menière's disease shows, the localisation of dysfunction within the labyrinth is of considerable importance. The selective investigation of crista and macula sensor organs and its time-dependent progression even provides information for the disease's staging.
In the retrospective trial presented here, 126 patients suffering from vertigo were tested by the methods described above. 10 of these patients who showed a triad of symptoms including vertigo attacks, unilateral sudden hearing loss and tinnitus were selected for this study. All 10 patients were tested within 48 hours after the last acute vertigo attack by means of caloric irrigation and VEMPs.
The function loss verified in saccular testing could be found in Menière's disease progression at an earlier stage than the utricular function loss. Most patients with a long history of vertigo attacks also suffered from a dysfunction of the semicircular canals.
The differential testing of the otolith function is a valid tool for the recognition of early labyrinth dysfunction in Menière's disease and could lead to an earlier onset of specific therapy. It also provides the base for a differentiated staging prior to therapy planning.
自多尔曼的研究以来,梅尼埃病个体间极其多变的自然病程已得到记录。梅尼埃病亚实体的描述表明,迷路内功能障碍的定位具有相当重要的意义。对嵴和黄斑感觉器官的选择性研究及其随时间的进展甚至为疾病分期提供了信息。
在本文所呈现的回顾性试验中,126名眩晕患者通过上述方法进行了检测。本研究选取了其中10名表现出眩晕发作、单侧突发性听力损失和耳鸣三联征症状的患者。所有10名患者在最后一次急性眩晕发作后48小时内通过冷热试验和前庭诱发肌源性电位进行了检测。
在球囊检测中证实的功能丧失在梅尼埃病进展中比椭圆囊功能丧失出现得更早。大多数有长期眩晕发作史的患者也存在半规管功能障碍。
耳石功能的鉴别检测是识别梅尼埃病早期迷路功能障碍的有效工具,可能导致更早开始特异性治疗。它还为治疗计划前的差异化分期提供了依据。