Yetişer Sertaç, Kertmen Mustafa
Department of Otolaryngology, Gülhane Military Medical School, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(1):18-21.
Physiological studies with experimental models of endolymphatic hydrops in Meniere's disease demonstrate some pressure changes at the level of round and oval window. Interestingly, conductive type hearing loss was observed in some patients during Meniere episodes. A close auditory follow-up of these patients may provide a better understanding of hydrodynamic changes of the hydrops and micromechanics of the inner ear.
Eighty-four patients (mean age 34.3 years; range 17 to 77 years) with Meniere's disease were enrolled in the study. Duration of Meniere symptoms ranged between six months to 22 years (mean 6.2 years). Longitudinal follow-up of patients was planned for three years. Bone and air conduction thresholds were averaged and the differences between the thresholds were calculated.
Twenty-four patients (28.4%) demonstrated air-bone gap at least at one frequency, the differences being 18.3, 11.8, 2.8, and 11.1 dB at 0.5, 1, 2, and 4 kHz, respectively. The average air-bone gap was 11.5 dB. The difference was the greatest at 0.5 kHz and the least at 2 kHz.
Low-frequency conductive hearing loss may be detected in Meniere's disease, which is apparently not indicative of middle ear pathology. High incidence of conductive involvement in patients who have had a recent episode of vertigo may indicate a distortion of vibratory movement of the stapes.
梅尼埃病内淋巴积水实验模型的生理学研究表明，圆窗和卵圆窗水平存在一些压力变化。有趣的是，部分患者在梅尼埃病发作期间出现传导性听力损失。对这些患者进行密切的听力随访，可能有助于更好地理解积水的流体动力学变化和内耳的微力学。
本研究纳入了84例梅尼埃病患者（平均年龄34.3岁；范围17至77岁）。梅尼埃病症状持续时间为6个月至22年（平均6.2年）。计划对患者进行为期三年的纵向随访。计算骨导和气导阈值的平均值以及阈值之间的差异。
24例患者（28.4%）至少在一个频率出现气骨导差，在0.5、1、2和4kHz时，差异分别为18.3、11.8、2.8和11.1dB。平均气骨导差为11.5dB。差异在0.5kHz时最大，在2kHz时最小。
梅尼埃病患者可能存在低频传导性听力损失，这显然不提示中耳病变。近期有眩晕发作的患者传导受累发生率较高，可能表明镫骨振动运动发生了畸变。
