House John W, Doherty Joni K, Fisher Laurel M, Derebery M Jennifer, Berliner Karen I
House Clinic and House Ear Institute, Clinical Studies Department, Los Angeles, CA 90057, USA.
Otol Neurotol. 2006 Apr;27(3):355-61. doi: 10.1097/00129492-200604000-00011.
Determine the prevalence and time interval for conversion from unilateral to bilateral involvement in Meniere's disease and cochlear hydrops.
Retrospective chart review in a tertiary otologic referral center.
232 patients diagnosed with Meniere's Disease (n=186) or cochlear hydrops (n=46) between 1959 and 2001, who visited the clinic over a five-year period between 1997-2001 and have at least 2 audiograms more than 12 months apart.
Prevalence of cochlear hydrops relative to Meniere's Disease, rate of progression from unilateral to bilateral involvement; interval between unilateral onset of symptoms and bilateral involvement; and rate of progression from cochlear hydrops to Meniere's disease.
Initial diagnosis was Meniere's disease in 71% and cochlear hydrops in 29% of all 950 hydropic patients presenting between 1997 and 2001. In the study sample, Meniere's disease was bilateral at presentation in 11%; an additional 12% (14% of unilaterals) became bilateral during the follow-up period. At presentation, 6.5% of cochlear hydrops patients were bilateral, with another 26% becoming bilateral. Conversion from cochlear hydrops to Meniere's disease occurred in 33% and some of these are included among the bilateral. The average time interval for conversion from unilateral to bilateral Meniere's was 7.6 years (SD=7.0 years).
Most otologists are aware of the potential for contralateral ear involvement and conversion from cochlear hydrops to Meniere's disease after diagnosis. These changes are significant, require long-term follow-up for detection, and may necessitate further treatment. Patients should be counseled regarding this potential when interventions are considered, especially with respect to ablative treatments.
确定梅尼埃病和耳蜗积水从单侧受累转变为双侧受累的患病率及时间间隔。
在一家三级耳科转诊中心进行回顾性病历审查。
1959年至2001年间诊断为梅尼埃病（n = 186）或耳蜗积水（n = 46）的232例患者，他们在1997 - 2001年的五年期间到该诊所就诊，且至少有两次间隔超过12个月的听力图。
耳蜗积水相对于梅尼埃病的患病率、从单侧受累进展为双侧受累的比率；单侧症状发作与双侧受累之间的间隔；以及从耳蜗积水进展为梅尼埃病的比率。
在1997年至2001年间就诊的所有950例积水患者中，初始诊断为梅尼埃病的占71%，耳蜗积水的占29%。在研究样本中，梅尼埃病初诊时双侧受累的占11%；在随访期间，另有12%（单侧患者的14%）变为双侧受累。初诊时，6.5%的耳蜗积水患者为双侧受累，另有26%变为双侧受累。33%的患者从耳蜗积水转变为梅尼埃病，其中一些包含在双侧受累患者中。梅尼埃病从单侧转变为双侧的平均时间间隔为7.6年（标准差 = 7.0年）。
大多数耳科医生在诊断后都意识到对侧耳受累以及从耳蜗积水转变为梅尼埃病的可能性。这些变化很显著，需要长期随访以检测，可能需要进一步治疗。在考虑干预措施时，尤其是消融治疗时，应向患者告知这种可能性。
