Paparella Michael M
Minnesota Ear, Head and Neck Clinic, 701 25(th) Avenue South, Suite 200, Minneapolis, MN 55454, USA.
Otolaryngol Clin North Am. 2006 Aug;39(4):713-21, vi. doi: 10.1016/j.otc.2006.03.001.
Meniere's disease can be observed uniquely in revisions of the conservative surgical procedure for endolymphatic sac enhancement, which preserves the labyrinth, unlike destructive procedures. Genetic anatomic abnormalities in patients lead to malabsorption of endolymph and symptoms of Meniere's that are reversed by endolymphatic sac enhancement, but disabling symptoms eventually may recur in a few cases and require revisional surgery. We observe developing pathophysiologic conditions intraoperatively and have modified our techniques to accommodate the redeveloped pathogenesis we observe and avoid complications found with earlier techniques. This conservative treatment allows patients (many of whom may develop bilateral Meniere's) to retain capacity to accept cochlear implants should they become advisable later.
梅尼埃病仅在为增强内淋巴囊而进行的保守性外科手术的翻修手术中可见，与破坏性手术不同，该手术保留了迷路。患者的基因解剖异常会导致内淋巴吸收不良以及梅尼埃病症状，而内淋巴囊增强术可逆转这些症状，但在少数情况下，致残症状最终可能会复发，需要进行翻修手术。我们在术中观察到不断发展的病理生理状况，并改进了我们的技术，以适应我们观察到的重新发展的发病机制，并避免早期技术中出现的并发症。这种保守治疗使患者（其中许多人可能会发展为双侧梅尼埃病）在日后建议使用时仍有能力接受人工耳蜗植入。
