Boudewyns A N, Wuyts F L, Hoppenbrouwers M, Ketelslagers K, Vanspauwen R, Forton G, Van de Heyning P H
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Acta Otolaryngol. 2005 Dec;125(12):1283-9. doi: 10.1080/00016480510012237.
Our data indicate that Meniett therapy is unlikely to be helpful in the long-term treatment of patients with severe, drug-resistant Ménière's disease (MD) in whom injection of intratympanic gentamicin (ITG) or another destructive procedure would otherwise be performed.
To investigate the value of Meniett therapy in patients with drug-resistant MD referred for injection of ITG.
Twelve patients referred for ITG treatment were followed during a 2-month period of Meniett therapy. Symptoms, functional level and hearing status were evaluated using a standardized staging system. Disease-specific quality-of-life measures were obtained before and after Meniett therapy. At the end of the study period, patients were followed for a mean of 37 months, thus providing long-term outcome data.
In two patients, Meniett treatment was interrupted after 1 month because of persistent severe vertigo. In the remaining 10 subjects, we found a significant decrease in the median number of vertigo spells from 10.0/month (25th-75th percentile 4.0-19.0) prior to treatment to 3.0/month (25th-75th percentile 1.5-4.5) after treatment (p = 0.02). There was, however, no improvement in hearing status, tinnitus, functional level or self-perceived dizziness handicap. Long-term (>1 year) follow-up data revealed that only 2 subjects preferred to continue Meniett therapy and that ablative surgery had to be performed in 6/12 study patients.
我们的数据表明，对于那些原本会接受鼓室内注射庆大霉素（ITG）或其他破坏性手术治疗的重度、耐药梅尼埃病（MD）患者，梅尼埃治疗法不太可能对其长期治疗有帮助。
探讨梅尼埃治疗法在转诊接受ITG注射的耐药MD患者中的价值。
对12名转诊接受ITG治疗的患者进行了为期2个月的梅尼埃治疗法随访。使用标准化分期系统评估症状、功能水平和听力状况。在梅尼埃治疗法前后获取特定疾病的生活质量指标。在研究期结束时，对患者平均随访37个月，从而提供长期结果数据。
2名患者在1个月后因持续性严重眩晕中断了梅尼埃治疗。在其余10名受试者中，我们发现眩晕发作的中位数从治疗前的每月10.0次（第25 - 75百分位数为4.0 - 19.0）显著降至治疗后的每月3.0次（第25 - 75百分位数为1.5 - 4.5）（p = 0.02）。然而，听力状况、耳鸣、功能水平或自我感知的头晕障碍并无改善。长期（>1年）随访数据显示，只有2名受试者倾向于继续梅尼埃治疗法，并且12名研究患者中有6名不得不接受消融手术。
