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梅尼埃病:在非洲人中罕见或诊断不足。

Meniere's disease: rare or underdiagnosed among Africans.

作者信息

Ibekwe T S, Ijaduola G T A

机构信息

Department of Otorhinolaryngology, College of Medicine University of Ibadan, University College Hospital Ibadan, Ibadan, Nigeria.

出版信息

Eur Arch Otorhinolaryngol. 2007 Dec;264(12):1399-403. doi: 10.1007/s00405-007-0377-y. Epub 2007 Jul 4.

Abstract

Meniere's disease can easily be misdiagnosed because several otological disorders mimic the disease. Conflicting reports on the incidence of this disease among the Africans had been documented. The goal of our study was to verify the prevalence and clinical features of Meniere's disease in WA sub-region. A 10 year (1996-2005) retrospective study carried out in our hospital. The diagnostic criteria for the disease were outlined and Oyedeji's social classification instrument was adapted for socio-economic stratification of patients. The method of treatment and prognostic out-come were discussed. Out of 11,463 patients seen within the period, 25 (16 females and 9 males) met the diagnostic criteria for Meniere's disease. The age ranged from 27 to 75 years (mean=47.2 SD13.2) and the most predominant age group was 41-50 years. Sixty-eight percent were of low socio-economic class and the rest high. About 84% had unilateral and 16% bilateral Meniere's disease. All the patients presented with tinnitus, vertigo and audiologically confirmed sensorineural hearing loss. CT-scan and MRI were used to rule out some differentials, while caloric and recruitment tests were used to strengthen the diagnosis. Treatment regimen (conservative) outcome: 72% had good improvement, 8% fair, while 20% absconded from follow-up. The prevalence of Meniere's disease in West African sub-region is 0.22%. This prevalence among Africans may not differ from the Caucasians. Under- or over-diagnosis of the disease previously must have been responsible for the contrasting results. Appropriate diagnostic tools are necessary for accurate diagnosis of the disease.

摘要

梅尼埃病很容易被误诊,因为几种耳科疾病会模仿这种病症。关于非洲人当中这种疾病发病率的报告相互矛盾。我们研究的目的是核实西非次区域梅尼埃病的患病率和临床特征。在我们医院进行了一项为期10年(1996 - 2005年)的回顾性研究。概述了该疾病的诊断标准,并采用奥耶德吉的社会分类工具对患者进行社会经济分层。讨论了治疗方法和预后结果。在该时间段内就诊的11463名患者中,25名(16名女性和9名男性)符合梅尼埃病的诊断标准。年龄范围为27至75岁(平均 = 47.2,标准差 = 13.2),最主要的年龄组是41 - 50岁。68%属于社会经济低阶层,其余为高阶层。约84%患有单侧梅尼埃病,16%为双侧。所有患者均出现耳鸣、眩晕且经听力检查确诊为感音神经性听力损失。使用CT扫描和MRI排除一些鉴别诊断,同时使用冷热试验和重振试验来强化诊断。治疗方案(保守治疗)结果:72%有良好改善,8%一般,而20%失访。西非次区域梅尼埃病的患病率为0.22%。非洲人当中的这一患病率可能与白种人没有差异。此前对该疾病的漏诊或误诊必定是导致结果相互矛盾的原因。准确诊断该疾病需要合适的诊断工具。

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