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[小剂量鼓室内注射庆大霉素对难治性梅尼埃病的影响]

[The effects of small dose of intratympanic gentamicin injection on intractable Meniere's disease].

作者信息

Dai Chunfu, Zhang Guoming, Zhang Ru, Liu Jianping, Chi Fanglu, Wang Zhengmin

机构信息

Department of Otology and Skull Base Surgery, Eye Ear Nose Throat Hospital, Fudan University, Shanghai, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Feb;21(4):151-3.

Abstract

OBJECTIVE

To explore the efficacy of small dose of intratympanic gentamicin injection on intractable Meniere's disease.

METHOD

Retrospectively study the efficacy of gentamicin intratympanic injection on intractable Meniere's disease. The end-point of treatment was determined based on bedside tests (Spontaneous Nystagmus test, Head shaking test and Head Thrust test), hearing tests, or the improvement of patients symptoms.

RESULT

Nineteen patients with Meniere's disease were treated with intratympanic gentamicin injection. Vertigo control was achieved in 17 patients (89%). Of them, vertigo of 5 patients was successfully controlled after single injection. Eight patients need double injections and 4 patients need the third injections to control the vertigo. Endolymphatic sac shunt was performed to 1 patient because he could not tolerate the fullness of ear due to injection. The remainder 2 patients with double injections showed no improvement of vertigo and rejected further treatment. Hearing was improved in two patients after gentamicin injection. Three patients complained of hearing loss after intratympanic gentamicin injection. The hearing of the other patients did not change.

CONCLUSION

Three weeks after using small dose of gentamicin intratympanic injection to treat intractable Meniere's disease, it was determined whether more injections is required. The results showed that by using this approach, the vertigo could be effectively controlled and the risk of hearing loss following intratympanic gentamicin injection could be reduced.

摘要

目的

探讨小剂量鼓室内注射庆大霉素治疗难治性梅尼埃病的疗效。

方法

回顾性研究鼓室内注射庆大霉素治疗难治性梅尼埃病的疗效。治疗终点根据床旁检查(自发性眼震试验、摇头试验和头脉冲试验)、听力检查或患者症状改善情况确定。

结果

19例梅尼埃病患者接受鼓室内庆大霉素注射治疗。17例(89%)患者眩晕得到控制。其中,5例患者单次注射后眩晕成功控制。8例患者需要注射两次,4例患者需要注射三次才能控制眩晕。1例患者因无法耐受注射引起的耳部胀满感而接受内淋巴囊分流术。其余2例接受两次注射的患者眩晕无改善,拒绝进一步治疗。庆大霉素注射后2例患者听力改善。3例患者鼓室内注射庆大霉素后出现听力下降。其他患者听力未改变。

结论

小剂量鼓室内注射庆大霉素治疗难治性梅尼埃病3周后,确定是否需要更多次注射。结果表明,采用这种方法可有效控制眩晕,并可降低鼓室内注射庆大霉素后听力损失的风险。

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